Healthcare Provider Details

I. General information

NPI: 1265470462
Provider Name (Legal Business Name): JOHN LUCIUS MCGEHEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1669 KIRBY PKWY SUITE 110
MEMPHIS TN
38120-4373
US

IV. Provider business mailing address

395 GRANDVIEW ST
MEMPHIS TN
38111-7607
US

V. Phone/Fax

Practice location:
  • Phone: 901-755-8891
  • Fax: 901-755-8820
Mailing address:
  • Phone: 901-844-1434
  • Fax: 901-844-1439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number14874
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number14874
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number14874
License Number StateTN
# 4
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number14874
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: