Healthcare Provider Details

I. General information

NPI: 1578259016
Provider Name (Legal Business Name): WHOLLY WOUNDS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2023
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 ERIN DR UNIT 771684
MEMPHIS TN
38117-4249
US

IV. Provider business mailing address

PO BOX 771684
MEMPHIS TN
38177-1684
US

V. Phone/Fax

Practice location:
  • Phone: 901-450-7470
  • Fax: 901-881-5944
Mailing address:
  • Phone: 901-450-7470
  • Fax: 901-881-5944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIEL SALLIS MURRELL
Title or Position: PHYSICIAN
Credential: MD
Phone: 901-450-7470