Doctor Name: | ESSIE MCCOLLOUGH |
NPI Number: | 1831424043 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 021157058 |
Business Practice Address: | 475 N Highland St 2a Memphis, TN - 381224544 |
Business Phone Number: | 9014887848 |
Business Fax Number: | 9013231868 |
Mailing Address: | 475 N Highland St, 2a MEMPHIS |
State: | TN |
Postal Code: | 381224544 |
Phone Number: | 9014887848 |
Fax Number: | 9013231868 |
NPI Enumeration Date: | 10/05/2009 |
NPI Last Update Date: | 10/21/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 172A00000X |
License Number: | 021157058 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Driver |
Taxonomy Specialization: | |
Taxonomy Definition: | A person employed to operate a motor vehicle as a carrier of persons or property. |