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Organization
TUPELO UROLOGY CENTER
Active
Organization
TUPELO UROLOGY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA NICOLE GARDNER (ADMINISTRATOR)
(662) 816-3791
Entity
Organization
Contact information
Practice address
2089 SOUTHRIDGE DR STE B, TUPELO, MS 38801-6478
(662) 234-1448
Mailing address
PO BOX 1013, OXFORD, MS 38655-1013
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
05/09/2024
Last updated
05/09/2024
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