Mid-South Rectal Clinic, Inc.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

36972 Issued in TN

Legal business name

MID-SOUTH RECTAL CLINIC, INC.

Practice address

6563 Stage Oaks Dr
Suite 100
Bartlett, TN 38134-2886

Phone

(901) 362-5252

Fax

(901) 369-4775

NPI assigned

Nov 1, 2006

Last updated

Feb 1, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael M. Fox, M.D.NPI 1942293063

Title

Provider/Owner

Phone

(901) 362-5252

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael M. Fox, M.D.

  • Surgery Physician
  • Bartlett, TN
  • NPI 1942293063
  Authorized official Same address or phone

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454284800000",
    "number": "1316024193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7550 LUCERNE DR",
            "address_2": "SUITE 405",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441306588",
            "telephone_number": "440-234-8833",
            "fax_number": "440-234-3313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6563 STAGE OAKS DR",
            "address_2": "SUITE 100",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381342886",
            "telephone_number": "901-362-5252",
            "fax_number": "901-369-4775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-SOUTH RECTAL CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2016-02-01",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "901-362-5252",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "36972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155546001",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01702559",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3727193",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael L. Parrish, D.D.S., P.C.
• Michelle a. Shelton, MD, LLC
• Mid South Vision Center PLLC
• Mid-South Dermatology, PC
• Mid-South Hemophilia and Thrombosis Center, Inc.
• Mid-South Urgent Care, PLLC
• Latrice Miller, FNP
• Robert G Miller, MD
• Courtney Michelle Millington, FNP-C
• Briana J Mills

• Surgery Physician in Bartlett, TN
• Providers in Bartlett, TN by specialty
• Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2016; 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.