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Poplar Avenue Clinic PLLC

NPI 1124588793ActiveOrganization· Obstetrics & Gynecology, Gynecologic Oncology· Memphis, TN

Obstetrics & Gynecology, Gynecologic Oncology in Memphis, Tennessee, registered in NPPES in March 2019. The authorized official on file is Huda Alaeddin, Office Manager. Enrolled in Medicare as part b supplier - clinic/group practice.

Overview

NPI1124588793
StatusActive
Entity typeOrganization
NPI issuedMar 20, 2019
Last updated in NPPESSep 6, 2022
Certified by providerSep 6, 2022

Specialties and licenses

TaxonomyCodeLicenseState
Obstetrics & Gynecology, Gynecologic Oncology Primary207VX0201X——
Radiology, Vascular & Interventional Radiology2085R0204X——
Surgery, Vascular Surgery2086S0129X——
Clinic/Center, Family Planning, Non-Surgical261QF0050X——
Clinic/Center, Multi-Specialty261QM1300X——
Clinic/Center, Medical Specialty261QM2500X——
Clinic/Center, Primary Care261QP2300X——
Clinic/Center, Urgent Care261QU0200X——
Physician Assistant363A00000X——
Physician Assistant, Medical363AM0700X——
Physician Assistant, Surgical363AS0400X——
Nurse Practitioner, Women's Health363LW0102X——
Nurse Anesthetist, Certified Registered367500000X——

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026No match—
New York OMIG · Nov 10, 2026No match—
Ohio Medicaid · Nov 10, 2026No match—
Pennsylvania Medicheck · Nov 10, 2026No match—
Washington HCA · Nov 10, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Enrolled Part B Supplier - Clinic/Group Practice (TN)

Medicare sources and data years

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