Provider Demographics
NPI:1285120063
Name:FRANCIS CAMILLO MD PLLC
Entity type:Organization
Organization Name:FRANCIS CAMILLO MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:XAVIER
Authorized Official - Last Name:CAMILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-233-6649
Mailing Address - Street 1:6005 PARK AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-5214
Mailing Address - Country:US
Mailing Address - Phone:901-767-9500
Mailing Address - Fax:901-767-0911
Practice Address - Street 1:6005 PARK AVE STE 400
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-5214
Practice Address - Country:US
Practice Address - Phone:901-767-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-05
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty