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NPI Code Detail

MEDICARE: DR. CONNIE HARRIS SCURTI DO

MEDICARE: DR. CONNIE HARRIS SCURTI DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician26779MS

General Provider Information

NPI Number : 1033449186
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CONNIE HARRIS SCURTI DO
Provider Business Mailing Address
First Line : 965 RIDGE LAKE BLVD STE 103
Second Line :
City : MEMPHIS
State : TN
Zip : 38120-9446
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 255 BAPTIST BLVD STE 301
Second Line :
City : COLUMBUS
State : MS
Zip : 39705-2006
Country : US
Telephone Number : 662-244-1705
Fax Number : 662-227-4301
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2010
Last Update Date : 08/21/2019

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Directions to “ DR. CONNIE HARRIS SCURTI DO” Practice Location

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