Healthcare Provider Details

I. General information

NPI: 1851130231
Provider Name (Legal Business Name): JUSTIN KAUR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2024
Last Update Date: 02/05/2025
Certification Date:
Deactivation Date: 01/14/2025
Reactivation Date: 02/05/2025

III. Provider practice location address

920 MADISON AVENUE UNIVERSITY OF TENNESSEE 920 MADISON AVENUE SUITE 447
MEMPHIS TN
38103
US

IV. Provider business mailing address

50 NORTH DUNLAP RESIDENT EDUCATION 6TH FLOOR RESEARCH TOWER
MEMPHIS TN
38103
US

V. Phone/Fax

Practice location:
  • Phone: 901-287-6756
  • Fax:
Mailing address:
  • Phone: 901-287-5319
  • 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: