Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 51976 | TN |
N | 207RH0002X | Hospice and Palliative Medicine | 51976 | TN |
NPI | 1609166016 |
---|---|
Provider Name | Austin Lawrence Dalgo |
First Address | Memphis, TN 38105-4625 |
Second Address | Memphis, TN 38105-4625 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2011 |
Last Update Date | 31/05/2016 |