Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 35064 | TN |
NPI | 1164418992 |
---|---|
Provider Name | Francis X Camillo |
First Address | Memphis, TN 38119-5214 |
Second Address | Memphis, TN 38119-5214 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2005 |
Last Update Date | 07/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3870194 | (05) | TN |
H53270 | (02) | TN |