Healthcare Provider Details
I. General information
NPI: 1578259016
Provider Name (Legal Business Name): WHOLLY WOUNDS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/17/2023
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1068 CRESHAVEN RD STE 501
MEMPHIS TN
38119-0800
US
IV. Provider business mailing address
PO BOX 771684
MEMPHIS TN
38177-1684
US
V. Phone/Fax
- Phone: 901-450-7470
- Fax: 901-881-5944
- Phone: 901-295-5100
- Fax: 901-295-5101
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RI0200X |
| Taxonomy | Infectious Disease Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DANIEL
SALLIS
MURRELL
Title or Position: PHYSICIAN
Credential: MD
Phone: 901-295-5100