Healthcare Provider Details

I. General information

NPI: 1174573992
Provider Name (Legal Business Name): MARSHA J ORCUTT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 02/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 HUMPHREYS CTR SUITE 23
MEMPHIS TN
38120-2369
US

IV. Provider business mailing address

P.O. BOX 1000, DEPT 34
MEMPHIS TN
38148-0001
US

V. Phone/Fax

Practice location:
  • Phone: 901-383-8860
  • Fax: 901-383-8985
Mailing address:
  • Phone: 901-383-8860
  • Fax: 901-383-8985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number35043632
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD43654
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: