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NPI Code Detail

MEDICARE: DR. LETHEL DILLARD DPH

MEDICARE: DR. LETHEL DILLARD DPH
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
1183500000XPharmacist00000023911TN

General Provider Information

NPI Number : 1528371820
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LETHEL DILLARD DPH
Provider Business Mailing Address
First Line : 4015 AUSTIN PEAY HWY
Second Line :
City : MEMPHIS
State : TN
Zip : 38128-2503
Country : US
Telephone Number : 901-373-4575
Fax Number : 901-373-5901
Provider Business Practice Location Address
First Line : 4015 AUSTIN PEAY HWY
Second Line :
City : MEMPHIS
State : TN
Zip : 38128-2503
Country : US
Telephone Number : 901-373-4575
Fax Number : 901-373-5901
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2010
Last Update Date : 07/15/2010

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Directions to “ DR. LETHEL DILLARD DPH” Practice Location

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