Modern Gynecology And Reproductive Health Pc

LBN: Modern Gynecology And Reproductive Health Pc
Modern Gynecology And Reproductive Health Pc is an health care organization with primary practice located at 1407 Union Ave Ste 1401 , Memphis TN 38104-3667. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecology, which is considered as the primary health care specialty. Modern Gynecology And Reproductive Health Pc can be contacted via phone (901) 701-1777, or through Lacy, Susan Northen via phone (901) 289-0915.

Contact Information

Primary practice address
1407 Union Ave Ste 1401 Memphis TN 38104-3667
Phone: (901) 701-1777
Fax: (901) 701-1778
Website:
Map and Directions
Authorized official contact:
Name: Lacy, Susan Northen Doctor of Medicine (MD)
Phone: (901) 289-0915

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X

Profile Details

NPI number 1962056036
LBN Legal business name Modern Gynecology And Reproductive Health Pc
DBA Doing business as
Authorized official Lacy, Susan Northen Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 27th, 2019
Last updated Nov 1st, 2019 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962056036 NPPES
Tennessee MEDICAID Q053117

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