Organization Active NPI

Mid South Neurology Clinic PLLC

  • Neurology Physician
  • Germantown, TN
National Provider Identifier
1720173859
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
MID SOUTH NEUROLOGY CLINIC PLLC
Practice address
8584 Cordes Circle
Germantown, TN 38139
Phone
(901) 531-7007
Fax
(901) 531-7008
NPI assigned
Oct 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Maroun T Dick, MDNPI 1942273826
Title
Physician
Phone
(901) 531-7007

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

8584 Cordes Circle
Germantown, TN 38139

Mailing address

8584 Cordes Circle
Germantown, TN 38139
Phone (901) 531-7007

National Provider Directory

National Provider Directory

Locations

8584 Cordes Cir
Germantown, TN 38139
Phone (901) 531-7007

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720173859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8584 CORDES CIRCLE",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "38139",
            "telephone_number": "901-531-7007",
            "fax_number": "901-531-7008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8584 CORDES CIRCLE",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "38139",
            "telephone_number": "901-531-7007",
            "fax_number": "901-531-7008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID SOUTH NEUROLOGY CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DICK",
        "authorized_official_first_name": "MAROUN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "901-531-7007",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.