Healthcare Provider Details

I. General information

NPI: 1023939568
Provider Name (Legal Business Name): KASHIF ALI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 MADISON AVE STE 447
MEMPHIS TN
38103-3438
US

IV. Provider business mailing address

920 MADISON AVE STE 447
MEMPHIS TN
38103-3438
US

V. Phone/Fax

Practice location:
  • Phone: 901-448-3714
  • Fax:
Mailing address:
  • Phone: 901-448-3714
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number390200000X
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: