1659128718 NPI number — MR. HARUTYUN DAVTYAN M.D.

Table of content: MR. HARUTYUN DAVTYAN M.D. (NPI 1659128718)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659128718 NPI number — MR. HARUTYUN DAVTYAN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DAVTYAN
Provider First Name:
HARUTYUN
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659128718
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/24/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
UNIVERSITY OF TENNESSEE HEALTH SCIENCE CENTER
Provider Second Line Business Mailing Address:
920 MADISON AVENUE, SUITE 447
Provider Business Mailing Address City Name:
MEMPHIS
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
38163
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
901-448-5364
Provider Business Mailing Address Fax Number:
901-448-6182

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
REGIONAL ONE HEALTH FIREFIGHTERS BURN CENTER
Provider Second Line Business Practice Location Address:
890 MADISON AVENUE
Provider Business Practice Location Address City Name:
MEMPHIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-351-3434
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/06/2024

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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