Healthcare Provider Details
I. General information
NPI: 1417117433
Provider Name (Legal Business Name): SOUTHERN SPINE SPECIALISTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/12/2008
Last Update Date: 10/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1500 W POPLAR AVE SUITE 201
COLLIERVILLE TN
38017-0601
US
IV. Provider business mailing address
PO BOX 372 DEPT 110
MEMPHIS TN
38101-0372
US
V. Phone/Fax
- Phone: 901-818-2168
- Fax: 901-682-9998
- Phone: 901-818-2168
- Fax: 901-682-9998
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XS0117X |
| Taxonomy | Orthopaedic Surgery of the Spine Physician |
| License Number | MD0000031246 |
| License Number State | TN |
VIII. Authorized Official
Name: DR.
PATRICK
M
CURLEE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 901-818-2168