Memphis Imaging and Pathology Mip

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

44D0912700 Issued in TN

Legal business name

MEMPHIS IMAGING AND PATHOLOGY MIP

Practice address

1417 Monroe Ave
Memphis, TN 38104-3634

Phone

(901) 272-7200

Fax

(901) 260-5916

NPI assigned

Feb 3, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Phillip Rodney Bowden, M.D.

Title

Medical Director

Phone

(901) 272-7200

Specialties & licenses 1

Addresses

Other names 1

• MIP Other name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1233619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233619200000",
    "number": "1043458730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 MONROE AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043634",
            "telephone_number": "901-272-7200",
            "fax_number": "901-260-5916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 MONROE AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043634",
            "telephone_number": "901-272-7200",
            "fax_number": "901-260-5916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMPHIS IMAGING AND PATHOLOGY MIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-03",
        "last_updated": "2009-02-03",
        "status": "A",
        "authorized_official_last_name": "BOWDEN",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "RODNEY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "901-272-7200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TN",
            "license": "44D0912700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MIP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Memphis Health Center, Inc.
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• Memphis Hospitalists, PLLC
• Memphis Infectious Diseases Consultants, PLLC
• Memphis Internal Medicine and Pediatrics
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• Memphis Internist, L.L.C.
• Memphis KG Property, LLC

• Clinical Medical Laboratory in Memphis, TN
• Providers in Memphis, TN by specialty
• Clinical Medical Laboratory in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.