Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 11675 | TN |
NPI | 1003488917 |
---|---|
Provider Name | Christopher Patrick Stonecipher |
First Address | Memphis, TN 38122-4601 |
Second Address | Cordova, TN 38018-7220 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2021 |
Last Update Date | 12/07/2021 |