Healthcare Provider Details

I. General information

NPI: 1508027491
Provider Name (Legal Business Name): CONSOLIDATED MEDICAL PRACTICES OF MEMPHIS,PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2008
Last Update Date: 12/22/2022
Certification Date: 12/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6799 GREAT OAKS RD
MEMPHIS TN
38138-2588
US

IV. Provider business mailing address

6799 GREAT OAKS RD SUITE 250
MEMPHIS TN
38138-2588
US

V. Phone/Fax

Practice location:
  • Phone: 901-821-8300
  • Fax:
Mailing address:
  • Phone: 901-821-8300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. SCOTT VOGELSANG
Title or Position: COO
Credential:
Phone: 901-261-5774