Collierville Medical Assoc Inc

NPI 1063608271 - Clinic/Center - 261QP2300X

NPI Details
NPI 1063608271
Enumeration Date 09/20/2007
Last Updated 09/20/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name ROBERT CHEATHAM ROBERT
Position PRESIDENT
Phone (901) 853-4747
Fax (901) 853-6716
Practice Location
151 N MAIN ST
COLLIERVILLE TN, 38017-2670, US
Phone (901) 853-4747
Fax (901) 853-6716
Business Location
151 N MAIN ST
COLLIERVILLE TN, 38017-2670, US
Phone (901) 853-4747
Fax (901) 853-6716
Toxanomy
Taxonomy Code 261QP2300X
License State Tennessee
License Number 007768
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According to our database, Collierville Medical Assoc Inc NPI is 1063608271, taxonomy code is 261QP2300X and license number is 007768, license state is located at Tennessee. Collierville Medical Assoc Inc physically located at 151 N Main St, Collierville TN, 38017-2670. NPI Number 1033115704 has the healthcare provider type.

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1063608271 NPI number is provided on an as is basis without warranty of any kind. 1063608271 is maintained by the National Plan & Provider Enumeration System. The contents of Collierville Medical Assoc Inc are for informational purposes only.