Healthcare Provider Details

I. General information

NPI: 1760800239
Provider Name (Legal Business Name): IAN SOLSKY MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2014
Last Update Date: 10/05/2023
Certification Date: 10/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6029 WALNUT GROVE RD STE 301
MEMPHIS TN
38120-2112
US

IV. Provider business mailing address

6029 WALNUT GROVE RD STE 301
MEMPHIS TN
38120-2112
US

V. Phone/Fax

Practice location:
  • Phone: 901-747-9081
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number69135
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: