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General NPI Number Information
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NPI Number | 1730056110
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Entity Type | Organization
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Legal Business Name | MEMPHIS THOROUGHBREDS, INC
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Dates
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Enumeration Date | 10/21/2025
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 7126 FERNBANK LN
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City | MEMPHIS
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State | TN
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Zip | 38125-4168
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Country | US
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Telephone | 901-314-2874
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Fax |
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Provider Business Mailing Address
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Address Line | 7126 FERNBANK LN
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City | MEMPHIS
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State | TN
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Zip | 38125-4168
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Country | US
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Telephone | 901-314-2874
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TOMMY WASHINGTON
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Credential | B.S., USATF I, II
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Telephone | 901-314-2874
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080S0010X
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Taxonomy Name | Pediatric Sports Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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