Healthcare Provider Details

I. General information

NPI: 1467554279
Provider Name (Legal Business Name): GEORGETTE R SEVIER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GEORGETTE R FINLEY M.D.

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 06/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1407 UNION AVENUE SUITE 200
MEMPHIS TN
38104-3600
US

IV. Provider business mailing address

1407 UNION AVENUE SUITE 200
MEMPHIS TN
38104-3600
US

V. Phone/Fax

Practice location:
  • Phone: 901-866-8360
  • Fax: 901-302-2360
Mailing address:
  • Phone: 901-866-8360
  • Fax: 901-302-2360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number20345
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: