Healthcare Provider Details

I. General information

NPI: 1154506210
Provider Name (Legal Business Name): SLEEP AND PULMOUNARY SPEACIALISTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2008
Last Update Date: 06/25/2023
Certification Date: 06/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

REGIONAL ONE EXTENDED CARE LTAC 890 MADISON AVE
MEMPHIS TN
38103
US

IV. Provider business mailing address

P.O. BOX 2285
CORDOVA TN
38088
US

V. Phone/Fax

Practice location:
  • Phone: 901-515-3028
  • Fax: 844-308-5077
Mailing address:
  • Phone: 865-776-7348
  • Fax: 844-308-5077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: ZEINAB ADAM
Title or Position: ACCOUNT MANAGER
Credential:
Phone: 865-776-7348