Healthcare Provider Details

I. General information

NPI: 1255118774
Provider Name (Legal Business Name): EMILY MARIE ESTES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2023
Last Update Date: 04/12/2024
Certification Date: 04/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 MADISON AVENUE SUITE 447
MEMPHIS TN
38163-2827
US

IV. Provider business mailing address

6325 HUMPHREYS BLVD
MEMPHIS TN
38120-2300
US

V. Phone/Fax

Practice location:
  • Phone: 901-522-7700
  • Fax:
Mailing address:
  • Phone: 901-522-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: