Healthcare Provider Details

I. General information

NPI: 1831209873
Provider Name (Legal Business Name): RALEIGH GROUP P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2860 COVINGTON PIKE
MEMPHIS TN
38128-8090
US

IV. Provider business mailing address

2860 COVINGTON PIKE
MEMPHIS TN
38128-8090
US

V. Phone/Fax

Practice location:
  • Phone: 901-252-6034
  • Fax: 901-252-6048
Mailing address:
  • Phone: 901-252-6034
  • Fax: 901-252-6048

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. CATHERINE ROLATER
Title or Position: INSURANCE MANAGER
Credential:
Phone: 901-252-6066