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NPI Code Detail

MEDICARE: ROGER S CICALA MD

MEDICARE: ROGER S CICALA MD
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
1208VP0014XInterventional Pain Medicine PhysicianMD14415TN

General Provider Information

NPI Number : 1689663239
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROGER S CICALA MD
Provider Business Mailing Address
First Line : 6325 HUMPHREYS BLVD
Second Line :
City : MEMPHIS
State : TN
Zip : 38120-2300
Country : US
Telephone Number : 901-522-7700
Fax Number : 901-522-2550
Provider Business Practice Location Address
First Line : 6325 HUMPHREYS BLVD
Second Line :
City : MEMPHIS
State : TN
Zip : 38120-2300
Country : US
Telephone Number : 901-522-7700
Fax Number : 901-522-2550
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2005
Last Update Date : 08/14/2007

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Directions to “ ROGER S CICALA MD” Practice Location

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