Healthcare Provider Details

I. General information

NPI: 1427754639
Provider Name (Legal Business Name): PRC PSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2023
Last Update Date: 03/01/2025
Certification Date: 03/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 POPLAR AVE STE 250
MEMPHIS TN
38119-3974
US

IV. Provider business mailing address

5175 ELMORE RD STE 9
MEMPHIS TN
38134-5629
US

V. Phone/Fax

Practice location:
  • Phone: 901-451-9577
  • Fax:
Mailing address:
  • Phone: 901-451-9577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: CHANDRA PRICE
Title or Position: NURSE PRACTITIONER
Credential:
Phone: 901-451-9577