Threlkeld, Stephen C

Threlkeld, Stephen C is an individual health care provider with primary practice located at 6029 Walnut Grove Rd Ste C002 , Memphis TN 38120-2112. He recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as his primary health care specialty. Threlkeld, Stephen C can be contacted via phone (901) 685-3490.

Contact Information

Primary practice address
6029 Walnut Grove Rd Ste C002 Memphis TN 38120-2112
Phone: (901) 685-3490
Fax: (901) 685-3499
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X MD28793 Tennessee

Profile Details

NPI number 1578530895
LBN Legal business name Threlkeld, Stephen C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 6th, 2006
Last updated Jan 2nd, 2019 - about 5 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 1578530895 NPPES
Mississippi MEDICAID 00124291
Mississippi MEDICAID 3721649
Mississippi MEDICAID 3811529
Mississippi MEDICAID 09016197
Mississippi Other 3155614
Mississippi MEDICAID 115434001

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