| Adult And Adolescent Medicine Clinics Pllc | |
|
3021 Brunswick Rd Ste 1105 Memphis TN 38133-4198 | |
| (901) 212-2579 | |
| (901) 405-0365 |
| Full Name | Adult And Adolescent Medicine Clinics Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3021 Brunswick Rd Ste 1105, Memphis, Tennessee |
| Authorized Official Name and Position | Mahmood Ali (PRESIDENT) |
| Authorized Official Contact | 9017263979 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adult And Adolescent Medicine Clinics Pllc Po Box 383377 Germantown TN 38183-3377 Ph: (901) 726-3979 | Adult And Adolescent Medicine Clinics Pllc 3021 Brunswick Rd Ste 1105 Memphis TN 38133-4198 Ph: (901) 212-2579 |
| NPI Number | 1538276704 |
|---|---|
| Provider Enumeration Date | 08/24/2006 |
| Last Update Date | 08/15/2023 |
| Medicare PECOS PAC ID | 2163597378 |
|---|---|
| Medicare Enrollment ID | O20080822000603 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538276704 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Mahmood Ali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518918937 PECOS PAC ID: 4082693031 Enrollment ID: I20040714001330 |
| Provider Name | Lisa M Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407953953 PECOS PAC ID: 4385699206 Enrollment ID: I20050314000814 |
| Provider Name | Evelyn L Stiles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841373206 PECOS PAC ID: 5092989855 Enrollment ID: I20111114000659 |
| Provider Name | Stacy R Gibson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720463425 PECOS PAC ID: 8628387263 Enrollment ID: I20151021000976 |
| Provider Name | Tracie Watkins Abel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437510773 PECOS PAC ID: 3375842354 Enrollment ID: I20160426000142 |
| Provider Name | Gerald Mcclain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326416736 PECOS PAC ID: 2769759380 Enrollment ID: I20170601001057 |
| Provider Name | James Leroy Longmire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508376393 PECOS PAC ID: 7416203005 Enrollment ID: I20180712001192 |
| Provider Name | Jessica Lynn Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922563832 PECOS PAC ID: 9931435633 Enrollment ID: I20190801000939 |
| Provider Name | Donna Luckett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609332840 PECOS PAC ID: 8729400395 Enrollment ID: I20200629000468 |
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