Organization Name: | JAMES H SHULL MD PC |
NPI Number: | 1053470021 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAMES HERBERT SHULL (PRESIDENT) |
Mailing Address: | 2900 Kirby Rd Suite 1 Memphis |
State: | TN US |
Postal Code: | 38119 |
Phone Number: | 9017570655 |
Fax Number: | 9017571608 |
NPI Enumeration Date: | 12/06/2006 |
NPI Last Update Date: | 01/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | MD17329 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |