Healthcare Provider Details

I. General information

NPI: 1699753954
Provider Name (Legal Business Name): CLINIC OF PLASTIC AND RECONSTRUCTIVE SURGERY, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 BROOKFIELD RD SUITE 100
MEMPHIS TN
38119-0853
US

IV. Provider business mailing address

1000 BROOKFIELD RD SUITE 100
MEMPHIS TN
38119
US

V. Phone/Fax

Practice location:
  • Phone: 901-765-4700
  • Fax: 901-685-2717
Mailing address:
  • Phone: 901-765-4700
  • Fax: 901-685-2717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES G MURPHY
Title or Position: PRESIDENT
Credential: M.D.
Phone: 901-765-4700