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General NPI Number Information
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NPI Number | 1053340166
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Entity Type | Organization
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Legal Business Name | MEMPHIS LUNG PHYSICIANS, P.C.
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 02/09/2010
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Provider Practice Location Address
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Address Line | 6025 WALNUT GROVE RD SUITE 508
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City | MEMPHIS
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State | TN
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Zip | 38120-2131
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Country | US
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Telephone | 901-767-5864
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Fax | 901-767-6591
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Provider Business Mailing Address
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Address Line | 6025 WALNUT GROVE RD SUITE 508
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City | MEMPHIS
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State | TN
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Zip | 38120-2131
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Country | US
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Telephone | 901-767-5864
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Fax | 901-767-6591
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. JENNY L UDOUJ
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Credential |
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Telephone | 901-767-5864
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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