Healthcare Provider Details

I. General information

NPI: 1497192678
Provider Name (Legal Business Name): ARTINELI FOOTCARE SOLUTIONS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2013
Last Update Date: 06/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 MADISON AVE SUITE 260
MEMPHIS TN
38104-6458
US

IV. Provider business mailing address

PO BOX 21
SOUTHAVEN MS
38671-0001
US

V. Phone/Fax

Practice location:
  • Phone: 901-500-5103
  • Fax: 901-310-9117
Mailing address:
  • Phone: 901-500-5103
  • Fax: 901-310-9117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number711
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number711
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number711
License Number StateTN

VIII. Authorized Official

Name: DR. SHANTA L GRIFFIN
Title or Position: PODIATRIST
Credential: DPM
Phone: 901-500-5103