Healthcare Provider Details

I. General information

NPI: 1346241064
Provider Name (Legal Business Name): PATRICK JOSEPH DEAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2005
Last Update Date: 06/05/2020
Certification Date: 06/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3495 HACKS CROSS RD
MEMPHIS TN
38125-8803
US

IV. Provider business mailing address

3495 HACKS CROSS RD
MEMPHIS TN
38125-8803
US

V. Phone/Fax

Practice location:
  • Phone: 901-526-7444
  • Fax: 901-526-0791
Mailing address:
  • Phone: 901-526-7444
  • Fax: 901-526-0791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberMD14742
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: