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General NPI Number Information
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NPI Number | 1396991832
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Entity Type | Organization
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Legal Business Name | MEMPHIS RETINA, PLLC
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Dates
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Enumeration Date | 08/15/2008
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Last Update Date | 02/11/2010
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Provider Practice Location Address
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Address Line | 1264 WESLEY DR SUITE 302
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City | MEMPHIS
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State | TN
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Zip | 38116-6400
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Country | US
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Telephone | 901-348-0415
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1000 DEPT 919
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City | MEMPHIS
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State | TN
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Zip | 38148-0919
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Country | US
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Telephone | 901-377-8727
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SETH L YOSER
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Credential | MD
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Telephone | 901-348-0415
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 25588
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License Number State | TN
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