Healthcare Provider Details

I. General information

NPI: 1457524209
Provider Name (Legal Business Name): ASHLEY ALLEN HENDRIX MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2008
Last Update Date: 12/23/2024
Certification Date: 12/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 UNION AVE STE 300
MEMPHIS TN
38104
US

IV. Provider business mailing address

P O BOX 1000 DEPT 457
MEMPHIS TN
38148-0001
US

V. Phone/Fax

Practice location:
  • Phone: 901-516-0792
  • Fax: 901-266-6415
Mailing address:
  • Phone: 901-275-3662
  • Fax: 901-271-0155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number51916
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberP5989
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number51916
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: