MEDICARE: WHOLLY WOUNDS, PLLC

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	207RI0200X	Infectious Disease Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578259016
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHOLLY WOUNDS, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 771684
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38177-1684
Country	:	US
Telephone Number	:	901-295-5100
Fax Number	:	901-295-5101

Provider Business Practice Location Address
First Line	:	1068 CRESHAVEN RD STE 501
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38119-0800
Country	:	US
Telephone Number	:	901-450-7470
Fax Number	:	901-881-5944

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. DANIEL SALLIS MURRELL
Credential	:	MD
Telephone Number	:	901-295-5100

Provider Enumeration Date	:	04/17/2023
Last Update Date	:	05/05/2026

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