Mirro, Betty J
Mirro, Betty J is an sole proprietor health care provider with primary practice located at 3085 Fountainside Dr Suite 202, Germantown TN 38138-7842. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Mirro, Betty J can be contacted via phone (901) 755-0550.Contact Information
Primary practice address
3085 Fountainside Dr Suite 202
Germantown TN 38138-7842
Phone: (901) 755-0550
Fax: (901) 755-0474
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 17702 | Tennessee |
Profile Details
| NPI number | 1497754790 |
|---|---|
| LBN Legal business name | Mirro, Betty J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 19th, 2005 |
| Last updated | Mar 8th, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497754790 | NPPES |
| Tennessee | MEDICAID | 3370933 | |
| Tennessee | Other | 621756596 |
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