| Doctor Name: | DR. JERRY LEE LOVELACE |
| NPI Number: | 1568571404 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 226835 |
| Business Practice Address: | 1488 Madison Ave Memphis, TN - 381042447 |
| Business Phone Number: | 9017264110 |
| Business Fax Number: | 9017264106 |
| Mailing Address: | 1488 Madison Ave, MEMPHIS |
| State: | TN |
| Postal Code: | 381042447 |
| Phone Number: | 9017264110 |
| Fax Number: | 9017264106 |
| NPI Enumeration Date: | 08/30/2006 |
| NPI Last Update Date: | 01/28/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 226835 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |