Healthcare Provider Details

I. General information

NPI: 1003494931
Provider Name (Legal Business Name): JOHN EDWARD VOELPEL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 06/20/2024
Certification Date: 06/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7736 AIRWAYS BLVD
SOUTHAVEN MS
38671-5306
US

IV. Provider business mailing address

965 RIDGE LAKE BLVD STE 315
MEMPHIS TN
38120-9401
US

V. Phone/Fax

Practice location:
  • Phone: 662-772-3700
  • Fax: 662-772-3719
Mailing address:
  • Phone: 901-227-7015
  • Fax: 901-227-8591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number33461
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: