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General NPI Number Information
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NPI Number | 1114556826
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Entity Type | Individual
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Provider Name | TRICIA GRACE MATHEW MD
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Gender | Female
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Dates
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Enumeration Date | 04/04/2020
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 6019 WALNUT GROVE RD
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City | MEMPHIS
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State | TN
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Zip | 38120-2113
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Country | US
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Telephone | 901-226-2800
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Fax | 901-226-2802
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Provider Business Mailing Address
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Address Line | 350 N HUMPHREYS BLVD
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City | MEMPHIS
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State | TN
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Zip | 38120-2177
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Country | US
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Telephone | 901-226-4003
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Fax | 901-227-8591
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number | 72426
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 72426
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036-166646
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License Number State | IL
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