Healthcare Provider Details

I. General information

NPI: 1508537754
Provider Name (Legal Business Name): ALLERGYONE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2021
Last Update Date: 02/02/2022
Certification Date: 02/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

995 S YATES RD STE 3
MEMPHIS TN
38119-0882
US

IV. Provider business mailing address

PO BOX 381662
GERMANTOWN TN
38183-1662
US

V. Phone/Fax

Practice location:
  • Phone: 901-512-8258
  • Fax: 901-252-0055
Mailing address:
  • Phone: 901-512-8258
  • Fax: 901-252-0055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: SAUL M GREENBUAM
Title or Position: AUTH OFFICIAL
Credential: MD
Phone: 901-512-8258