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Organization
UROLOGY GROUP PC
Active
Organization
UROLOGY GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH A EDDLESTONE (CONSULTANT)
(901) 271-2272
Entity
Organization
Contact information
Practice address
401 SOUTHCREST CIR, SUITE 201, SOUTHAVEN, MS 38671
(662) 349-4329
Mailing address
401 SOUTHCREST CIR, SUITE 201, SOUTHAVEN, MS 38671-6726
(662) 349-4329
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09070511
—
MS
Enumeration date
05/29/2008
Last updated
08/29/2018
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