Mid-South Imaging & Therapeutics, P.A.

LBN: Mid-South Imaging & Therapeutics, P.A.
Mid-South Imaging & Therapeutics, P.A. is an health care organization with primary practice located at 7600 Wolf River Blvd. #200, Germantown TN 38138. The organization recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Diagnostic Radiology, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Allopathic & Osteopathic Physicians / Diagnostic Radiology is the primary health care specialty. Mid-South Imaging & Therapeutics, P.A. can be contacted via phone (901) 747-1000, or through Ellzey, John A via phone (901) 473-6406.

Contact Information

Primary practice address
7600 Wolf River Blvd. #200 Germantown TN 38138
Phone: (901) 747-1000
Fax: (901) 747-1001
Website:
Map and Directions
Authorized official contact:
Name: Ellzey, John A Doctor of Medicine (MD)
Phone: (901) 473-6406

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X

Profile Details

NPI number 1043260763
LBN Legal business name Mid-South Imaging & Therapeutics, P.A.
DBA Doing business as
Authorized official Ellzey, John A Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 11th, 2006
Last updated Aug 11th, 2021 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043260763 NPPES
Tennessee Other 0022687 GROUP TN BCBS #
Tennessee MEDICAID 09013816 GROUP TN BCBS #
Tennessee MEDICAID 107365002 GROUP TN BCBS #
Tennessee MEDICAID 3373325 GROUP TN BCBS #
Tennessee MEDICAID 508212206 GROUP TN BCBS #
Tennessee Other 86018 GROUP TN BCBS #

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