MEDICARE: MRS. LOUISE ANNE HARPER DAWKINS PT, MPT

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	208100000X	Physical Medicine & Rehabilitation Physician	6854	TN

General Provider Information

NPI Number	:	1629619416
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LOUISE ANNE HARPER DAWKINS PT, MPT

Provider Business Mailing Address
First Line	:	6768 PAPER BIRCH CV
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38119-6700
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2059 S HOUSTON LEVEE RD STE 117
Second Line	:
City	:	GERMANTOWN
State	:	TN
Zip	:	38139-6970
Country	:	US
Telephone Number	:	901-221-9221
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2019
Last Update Date	:	10/02/2019

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