Healthcare Provider Details

I. General information

NPI: 1659316321
Provider Name (Legal Business Name): ENDOCRINOLOGY CLINIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4913 RALEIGH COMMON DR SUITE 201
MEMPHIS TN
38128-2485
US

IV. Provider business mailing address

PO BOX 803
MEMPHIS TN
38101-0803
US

V. Phone/Fax

Practice location:
  • Phone: 901-386-7870
  • Fax: 901-386-7573
Mailing address:
  • Phone: 901-757-2345
  • Fax: 901-757-9065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LAKSHMI KRISHNAMURTHI
Title or Position: PHYSICIAN
Credential: M.D., F.A.C.E.
Phone: 901-757-2345