NPI 1801224910

Diamond One Healthcare

Organisation Exclusive Provider Organization Memphis, TN

Practice location

Address: 3514 Clearbrook St, Memphis, TN 38118-5547
Phone: (901) 362-6015
Fax: (901) 405-5106

Authorised official

Name: Charles Edward Reynolds
Title: Ceo
Phone: (901) 362-6015

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 113004427 (TN)

Other Exclusive Provider Organization providers in Tennessee →

Registry record

NPI: 1801224910
Entity type: Organization
NPI issued: 29 Oct 2013
Record last updated: 29 Oct 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.