Healthcare Provider Details

I. General information

NPI: 1316109531
Provider Name (Legal Business Name): CALEY MICHELLE SPOTTS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2008
Last Update Date: 01/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6019 WALNUT GROVE RD
MEMPHIS TN
38120-2113
US

IV. Provider business mailing address

PO BOX 11446
MEMPHIS TN
38111-0446
US

V. Phone/Fax

Practice location:
  • Phone: 901-842-1473
  • Fax: 901-844-1439
Mailing address:
  • Phone: 901-842-1473
  • Fax: 901-844-1439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberE6497
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD48804
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: