Stidham, Gregory L

Stidham, Gregory L is an individual health care provider with primary practice located at 1910 Nonconnah Blvd Suite 120, Memphis TN 38132-2113. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine, which is considered as his primary health care specialty. Stidham, Gregory L can be contacted via phone (901) 448-2300.

Contact Information

Primary practice address
1910 Nonconnah Blvd Suite 120 Memphis TN 38132-2113
Phone: (901) 448-2300
Fax: (901) 448-6657
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X 12680 Tennessee

Profile Details

NPI number 1366409666
LBN Legal business name Stidham, Gregory L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 28th, 2006
Last updated Jul 8th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366409666 NPPES
Tennessee MEDICAID 3180615

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