Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | 39003 | TN |
N | 207R00000X | Internist | 19274 | MS |
N | 111NI0900X | Internist | 19274 | MS |
N | 208000000X | Pediatrician | 19274 | MS |
NPI | 1295735454 |
---|---|
Provider Name | Dr. Teresa L Fritts |
First Address | Memphis, TN 38112-4304 |
Second Address | Southaven, MS 38672-9303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I27883 | (02) | TN |