Healthcare Provider Details

I. General information

NPI: 1518971951
Provider Name (Legal Business Name): FAMILY MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2006
Last Update Date: 08/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 EAST HIGHWAY 72
COLLIERVILLE TN
38017-2943
US

IV. Provider business mailing address

126 EAST HIGHWAY 72
COLLIERVILLE TN
38017-2943
US

V. Phone/Fax

Practice location:
  • Phone: 901-507-7007
  • Fax: 901-507-7008
Mailing address:
  • Phone: 901-507-7007
  • Fax: 901-507-7008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170100000X
TaxonomyPh.D. Medical Genetics
License Number
License Number State

VIII. Authorized Official

Name: DWAYNE D FINDLEY
Title or Position: OWNER
Credential: M.D.
Phone: 901-507-7007