Ear Nose And Throat Surgical Group
LBN: Ear Nose And Throat Surgical Group
Ear Nose And Throat Surgical Group is an health care organization with primary practice located at 970 Lakeland Dr Ste 40 , Jackson MS 39216-4640. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty.
Ear Nose And Throat Surgical Group can be contacted via phone (601) 200-4850, or through Wallace, Mickey P via phone (601) 898-7000.
Contact Information
Primary practice address
970 Lakeland Dr Ste 40
Jackson MS 39216-4640
Phone: (601) 200-4850
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Other Service Providers / Specialist | 174400000X | 08819 | Mississippi |
Profile Details
NPI number | 1699810069 |
---|---|
LBN Legal business name | Ear Nose And Throat Surgical Group |
DBA Doing business as | |
Authorized official | Wallace, Mickey P Doctor of Medicine (MD) |
Entity | Organization |
Organization subpart 1 | No |
Enumeration date | Feb 21st, 2007 |
Last updated | Aug 10th, 2011 - about 13 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1699810069 | NPPES |
Mississippi | MEDICAID | 04387064 |
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