Healthcare Provider Details

I. General information

NPI: 1548903305
Provider Name (Legal Business Name): ROBERT JAMES HEUSNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2022
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6225 HUMPHREYS BLVD
MEMPHIS TN
38120-2373
US

IV. Provider business mailing address

6225 HUMPHREYS BLVD
MEMPHIS TN
38120-2373
US

V. Phone/Fax

Practice location:
  • Phone: 901-227-9875
  • Fax:
Mailing address:
  • Phone: 901-227-9875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number77706
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: