Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 30525 | TN |
Y | 2081P2900X | Pain Medicine | 30525 | TN |
NPI | 1396748331 |
---|---|
Provider Name | Michael J Sorensen |
First Address | Memphis, TN 38119-5742 |
Second Address | Memphis, TN 38120-4023 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2005 |
Last Update Date | 29/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000120000 | (05) | MS |
110318002 | (05) | AR |
1255827 | CIGNA (01) | TN |
12608 | TLC (01) | TN |
135333001 | (05) | AR |
250009146 | RAILROAD MEDICARE (01) | TN |
3091702 | BLUE CROSS (01) | TN |
3371161 | (05) | TN |
3825983 | (05) | TN |
5015681 | AETNA (01) | TN |
620819926 | AETNA (01) | TN |
620819926 | BCBS (01) | MS |
620819926 | CIGNA (01) | TN |
620819926 | TRICARE (01) | TN |
7187860 | (05) | MS |
E47051 | (02) | TN |