Healthcare Provider Details

I. General information

NPI: 1710082987
Provider Name (Legal Business Name): WILLIAM HANNA KUTTEH M.D., PH.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 HUMPHREYS CTR SUITE 307
MEMPHIS TN
38120-2353
US

IV. Provider business mailing address

80 HUMPHREYS CTR SUITE 307
MEMPHIS TN
38120-2353
US

V. Phone/Fax

Practice location:
  • Phone: 901-747-2229
  • Fax: 901-747-4446
Mailing address:
  • Phone: 901-747-2229
  • Fax: 901-747-4446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberMD27765
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number12804
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberJ0561
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: