Healthcare Provider Details

I. General information

NPI: 1376684407
Provider Name (Legal Business Name): CARLOS SPRAGLING RT,RDMS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4299 ELVIS PRESLEY BLVD
MEMPHIS TN
38116-6435
US

IV. Provider business mailing address

4299 ELVIS PRESLEY BLVD
MEMPHIS TN
38116-6435
US

V. Phone/Fax

Practice location:
  • Phone: 901-396-6333
  • Fax: 901-396-1222
Mailing address:
  • Phone: 901-396-6333
  • Fax: 901-396-1222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2471C3402X
TaxonomyRadiography Radiologic Technologist
License Number119244
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number6350
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: