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General NPI Number Information
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NPI Number | 1326741844
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Entity Type | Organization
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Legal Business Name | MID-SOUTH URGENT CARE, PLLC
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Dates
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Enumeration Date | 03/23/2023
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 5905 STAGE RD
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City | BARTLETT
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State | TN
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Zip | 38134-4521
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Country | US
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Telephone | 901-779-8657
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Fax | 901-791-4208
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Provider Business Mailing Address
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Address Line | PO BOX 5165
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City | MEMPHIS
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State | TN
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Zip | 38101-5165
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Country | US
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Telephone | 901-779-8657
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Fax | 901-791-4208
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Authorized Official
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Title or Position | PRESIDENT
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Name | MOHAMMED BAH
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Credential | MD
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Telephone | 901-821-0338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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