Provider Demographics
NPI:1316331234
Name:FOCUS SLEEP CENTER OF DESOTO, LLC
Entity type:Organization
Organization Name:FOCUS SLEEP CENTER OF DESOTO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEVIN
Authorized Official - Middle Name:DUANE
Authorized Official - Last Name:DONALDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-461-8009
Mailing Address - Street 1:7420 GUTHRIE DR N
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-5876
Mailing Address - Country:US
Mailing Address - Phone:662-349-9802
Mailing Address - Fax:662-349-9810
Practice Address - Street 1:7420 GUTHRIE DR N
Practice Address - Street 2:SUITE 101
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-5876
Practice Address - Country:US
Practice Address - Phone:662-349-9802
Practice Address - Fax:662-349-9810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-28
Last Update Date:2015-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory