Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0102X | Surgical Critical Care | 62468 | TN |
Y | 2086S0120X | Pediatric Surgery | 62468 | TN |
NPI | 1508824541 |
---|---|
Provider Name | Howard I Pryor |
First Address | Memphis, TN 38103-2802 |
Second Address | Memphis, TN 38105-4625 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 12/03/2021 |