MEDICARE: METHODIST SPECIALTY PHYSICIANS, LLC

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
1	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician
2	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician

General Provider Information

NPI Number	:	1457557027
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	METHODIST SPECIALTY PHYSICIANS, LLC

Provider Business Mailing Address
First Line	:	6400 SHELBY VIEW DR STE 101
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38134-7659
Country	:	US
Telephone Number	:	901-516-1400
Fax Number	:	901-516-1401

Provider Business Practice Location Address
First Line	:	6400 SHELBY VIEW DR STE 101
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38134-7659
Country	:	US
Telephone Number	:	901-516-1400
Fax Number	:	901-516-1401

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MR. GINA BAPTISTE
Credential	:
Telephone Number	:	901-516-1400

Provider Enumeration Date	:	06/21/2007
Last Update Date	:	01/13/2021

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