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General NPI Number Information
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NPI Number | 1609166016
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Entity Type | Individual
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Provider Name | AUSTIN LAWRENCE DALGO M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/19/2011
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 870 E MCLEMORE AVE
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City | MEMPHIS
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State | TN
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Zip | 38106-3218
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Country | US
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Telephone | 901-448-2200
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Fax | 901-448-8485
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Provider Business Mailing Address
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Address Line | 1068 CRESTHAVEN RD STE 300
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City | MEMPHIS
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State | TN
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Zip | 38119-0809
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Country | US
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Telephone | 901-866-8864
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Fax |
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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 | 51976
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | 51976
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 2080H0002X
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Taxonomy Name | Pediatric Hospice and Palliative Medicine Physician
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License Number | 51976
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 51976
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License Number State | TN
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