Healthcare Provider Details

I. General information

NPI: 1427238195
Provider Name (Legal Business Name): MEMPHIS HAND CENTER
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

5699 GETWELL RD BLDG E, SUTIE 4
SOUTHAVEN MS
38672-7312
US

IV. Provider business mailing address

5699 GETWELL RD BLDG E, SUTIE 4
SOUTHAVEN MS
38672-7312
US

V. Phone/Fax

Practice location:
  • Phone: 662-536-4695
  • Fax: 662-536-4696
Mailing address:
  • Phone: 662-536-4695
  • Fax: 662-536-4696

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: MRS. JULIE N DIXON
Title or Position: OWNER
Credential: OT,CHT
Phone: 901-761-4263