Provider Demographics
NPI:1144273558
Name:MEMPHIS CARDIOLOGY PLC
Entity type:Organization
Organization Name:MEMPHIS CARDIOLOGY PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KISHORE
Authorized Official - Middle Name:K
Authorized Official - Last Name:ARCOT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-767-6765
Mailing Address - Street 1:PO BOX 740209 DEPT 1051
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374
Mailing Address - Country:US
Mailing Address - Phone:901-767-6765
Mailing Address - Fax:901-767-9639
Practice Address - Street 1:6005 PARK AVE
Practice Address - Street 2:SUITE 225 B
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-5202
Practice Address - Country:US
Practice Address - Phone:901-767-6765
Practice Address - Fax:901-767-9639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3725618Medicaid
AR154522002Medicaid
MS04787095Medicaid
TN3725618Medicaid
TN3725618Medicare ID - Type UnspecifiedMEDICARE