Healthcare Provider Details
I. General information
NPI: 1003435793
Provider Name (Legal Business Name): DANIEL DAVID AUSTIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/13/2020
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6799 GREAT OAKS RD STE 200
MEMPHIS TN
38138-2581
US
IV. Provider business mailing address
6799 GREAT OAKS RD STE 200
MEMPHIS TN
38138-2581
US
V. Phone/Fax
- Phone: 901-259-0090
- Fax: 901-259-0091
- Phone: 901-259-0090
- Fax: 901-259-0091
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RR0500X |
| Taxonomy | Rheumatology Physician |
| License Number | 72158 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: