Organization Active NPI

Mid South Urology P C

  • Specialist
  • Cordova, TN
National Provider Identifier
1154543577
Registry record updated Apr 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
MID SOUTH UROLOGY P C
Practice address
640 N Germantown Pkwy
Cordova, TN 38018-6210
Phone
(901) 753-9821
Fax
(901) 753-3537
NPI assigned
May 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2011

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

Authorized official

Name
Yair Walzer, M.D.
Title
President
Phone
(901) 753-9821

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

640 N Germantown Pkwy
Cordova, TN 38018-6210

Mailing address

640 N. Germantown Pkwy
Cordova, TN 38018
Phone (901) 753-9821

National Provider Directory

National Provider Directory

Locations

228 W Tyler Ave
Ste 202
West Memphis, AR 72301
Phone (870) 732-5070

228 W Tyler Ave
Ste 201
West Memphis, AR 72301
Phone (870) 732-5070

8066 Walnut Run Rd
Cordova, TN 38018
Phone (901) 410-3595

640 N Germantown Pkwy
Cordova, TN 38018
Phone (901) 753-9821

3980 New Covington Pike
Ste 304
Memphis, TN 38128

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302048000000",
    "number": "1154543577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 N. GERMANTOWN PKWY",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "38018",
            "telephone_number": "901-753-9821",
            "fax_number": "901-753-3537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 N GERMANTOWN PKWY",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380186210",
            "telephone_number": "901-753-9821",
            "fax_number": "901-753-3537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID SOUTH UROLOGY P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2011-04-06",
        "status": "A",
        "authorized_official_last_name": "WALZER",
        "authorized_official_first_name": "YAIR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-753-9821",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordova, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2011; 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.