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David A Deneka

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NPI Number Detailed Information

Provider Information:

Name: David A Deneka
Gender: M
Provider License Number If Given: 29319

NPI Information:

NPI: 1871596882
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 5/23/2005

Last Update Date: 6/11/2019

Provider Business Mailing Address:

Address: 6077 PRIMACY PKWY STE 140
Memphis, TN 38119
Phone Number: 9016413000
Fax Number: 9012591698

Provider Business Practice Location Address:

Address: 6286 BRIARCREST AVE STE 200
Memphis, TN 38120
Phone Number: 9016413000
Fax Number: 9012591698

Provider Taxonomy:

Primary: 207X00000X
Secondary (if any): 207X00000X
State: TN

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