Healthcare Provider Details

I. General information

NPI: 1144400813
Provider Name (Legal Business Name): MEMPHIS HAND CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2007
Last Update Date: 01/21/2015
Certification Date:
Deactivation Date: 09/03/2014
Reactivation Date: 01/21/2015

III. Provider practice location address

156 HIGHWAY 51 S
BATESVILLE MS
38606-2552
US

IV. Provider business mailing address

447 HIGHWAY 6 E
BATESVILLE MS
38606-3001
US

V. Phone/Fax

Practice location:
  • Phone: 662-578-2110
  • Fax: 662-578-2108
Mailing address:
  • Phone: 662-578-2110
  • Fax: 662-578-2108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: LESLIE MACON DUKES
Title or Position: OWNER
Credential: OT,CHT
Phone: 662-578-2110