Basic Information
| Provider Information | |||||||||
| NPI: | 1578529202 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ADAMS-GRAVES | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1407 UNION AVE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381043600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9018668813 | ||||||||
| FaxNumber: | 9013022120 | ||||||||
| Practice Location | |||||||||
| Address1: | 880 MADISON AVE | ||||||||
| Address2: | |||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381033409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9015456969 | ||||||||
| FaxNumber: | 9015456424 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/21/2006 | ||||||||
| LastUpdateDate: | 12/19/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 19562 | TN | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RH0003X | 19562 | TN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 3047321 | 05 | TN | MEDICAID |