Healthcare Provider Details

I. General information

NPI: 1235187949
Provider Name (Legal Business Name): MEMPHIS PSYCHIATRIC AND ADDICTION CLINIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 07/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8356 SILVERWIND DR
MEMPHIS TN
38125-0767
US

IV. Provider business mailing address

8356 SILVERWIND DR
MEMPHIS TN
38125-0767
US

V. Phone/Fax

Practice location:
  • Phone: 901-273-2368
  • Fax: 901-273-2351
Mailing address:
  • Phone: 901-273-2368
  • Fax: 901-273-2351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RADWAN R KHURI
Title or Position: OWNER/PRESIDENT
Credential: MD
Phone: 901-273-2368