| Park Highland Medical Clinic, Pllc | |
|
3836 Park Ave Memphis TN 38111-6633 | |
| (901) 324-3984 | |
| Not Available |
| Full Name | Park Highland Medical Clinic, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 3836 Park Ave, Memphis, Tennessee |
| Authorized Official Name and Position | Sudha Prasad (PHYSICIAN) |
| Authorized Official Contact | 9013243984 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Highland Medical Clinic, Pllc Po Box 17962 Memphis TN 38187-0962 Ph: () - | Park Highland Medical Clinic, Pllc 3836 Park Ave Memphis TN 38111-6633 Ph: (901) 324-3984 |
| NPI Number | 1689855124 |
|---|---|
| Provider Enumeration Date | 11/26/2007 |
| Last Update Date | 02/19/2009 |
| Medicare PECOS PAC ID | 9931258266 |
|---|---|
| Medicare Enrollment ID | O20090515000566 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689855124 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| Provider Name | Bheerendra R Prasad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831318286 PECOS PAC ID: 4789778986 Enrollment ID: I20070919000391 |
| Provider Name | Sudha R Prasad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013083781 PECOS PAC ID: 7315027117 Enrollment ID: I20080107000375 |
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