Healthcare Provider Details

I. General information

NPI: 1831060961
Provider Name (Legal Business Name): MEMPHIS CHILDREN'S SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2025
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 HUMPHREYS CENTER DR STE 310
MEMPHIS TN
38120-2361
US

IV. Provider business mailing address

80 HUMPHREYS CENTER DR STE 310
MEMPHIS TN
38120-2361
US

V. Phone/Fax

Practice location:
  • Phone: 301-494-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY WHEELER
Title or Position: CEO
Credential:
Phone: 301-494-3000