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NPI Code Detail

MEDICARE: MEMPHIS AND SHELBY COUNTY HEALTH DEPT.

MEDICARE: MEMPHIS AND SHELBY COUNTY HEALTH DEPT.
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 Physician26170TN
2208000000XPediatrics Physician20023TN
3207Q00000XFamily Medicine Physician36735TN

General Provider Information

NPI Number : 1073514055
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEMPHIS AND SHELBY COUNTY HEALTH DEPT.
Provider Business Mailing Address
First Line : 877 JEFFERSON AVE
Second Line : 5TH FLOOR ADAMS PAVILION
City : MEMPHIS
State : TN
Zip : 38103-2807
Country : US
Telephone Number : 901-272-0387
Fax Number : 901-272-0292
Provider Business Practice Location Address
First Line : 1064 BREEDLOVE ST
Second Line :
City : MEMPHIS
State : TN
Zip : 38107-2805
Country : US
Telephone Number : 901-515-5400
Fax Number : 901-526-1208
Authorized Official
Title or Position : CONTROLLER
Name : MR. CLAYTON MOORE
Credential :
Telephone Number : 901-272-0387
Provider Enumeration Date : 08/02/2005
Last Update Date : 09/11/2025

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Directions to “MEMPHIS AND SHELBY COUNTY HEALTH DEPT. ” Practice Location

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