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General NPI Number Information
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NPI Number | 1720031289
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Entity Type | Organization
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Legal Business Name | MEMPHIS NEPHROLOGY ASSOCIATES
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 04/15/2011
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Provider Practice Location Address
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Address Line | 6005 PARK AVE SUITE 626B
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City | MEMPHIS
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State | TN
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Zip | 38119-5202
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Country | US
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Telephone | 901-767-4799
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Fax | 901-767-4058
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Provider Business Mailing Address
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Address Line | 6005 PARK AVE SUITE 626B
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City | MEMPHIS
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State | TN
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Zip | 38119-5202
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Country | US
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Telephone | 901-767-4799
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Fax | 901-767-4058
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. ALAGIRI P SWAMY
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Credential | M.D.
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Telephone | 901-767-4799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD13716
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License Number State | TN
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