MEDICARE: DR. ADAM BENJAMIN LIBBY DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	927	TN

General Provider Information

NPI Number	:	1639732126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM BENJAMIN LIBBY DPM

Provider Business Mailing Address
First Line	:	7878 WINCHESTER RD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38125-2307
Country	:	US
Telephone Number	:	901-428-6823
Fax Number	:	901-756-4413

Provider Business Practice Location Address
First Line	:	7878 WINCHESTER RD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38125-2307
Country	:	US
Telephone Number	:	901-757-0046
Fax Number	:	901-756-4413

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

Provider Enumeration Date	:	04/19/2019
Last Update Date	:	07/26/2022

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