Healthcare Provider Details

I. General information

NPI: 1538789664
Provider Name (Legal Business Name): BRIAN ALEXANDER TONG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2020
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6325 HUMPHREYS BLVD
MEMPHIS TN
38120-2300
US

IV. Provider business mailing address

6325 HUMPHREYS BLVD
MEMPHIS TN
38120-2300
US

V. Phone/Fax

Practice location:
  • Phone: 901-522-7700
  • Fax: 901-522-2600
Mailing address:
  • Phone: 901-522-4878
  • Fax: 901-522-2600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number37322
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number76845
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberE-20786
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: