Healthcare Provider Details

I. General information

NPI: 1851317309
Provider Name (Legal Business Name): CHRISTOPHER T SOMOGYI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 04/11/2023
Certification Date: 04/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1661 INTERNATIONAL PLACE DRIVE
MEMPHIS TN
38120
US

IV. Provider business mailing address

1661 INTERNATIONAL PLACE DRIVE
MEMPHIS TN
38120
US

V. Phone/Fax

Practice location:
  • Phone: 901-685-2696
  • Fax: 901-682-9747
Mailing address:
  • Phone: 901-685-2696
  • Fax: 901-682-9747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number2004035465
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number39462
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: