Healthcare Provider Details

I. General information

NPI: 1902538259
Provider Name (Legal Business Name): CG&T SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2022
Last Update Date: 06/27/2022
Certification Date: 06/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 W BROOKHAVEN CIR
MEMPHIS TN
38117-4503
US

IV. Provider business mailing address

721 W BROOKHAVEN CIR
MEMPHIS TN
38117-4503
US

V. Phone/Fax

Practice location:
  • Phone: 901-767-8077
  • Fax: 901-767-8861
Mailing address:
  • Phone: 901-767-8077
  • Fax: 901-767-8861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: RICHARD HATHCOCK
Title or Position: OWNER
Credential:
Phone: 901-497-3805