# CUNNINGHAM PHYSICAL MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285637090
- **Authorized official:** DR. MARK L CUNNINGHAM MD (OWNER)
- **Authorized official phone:** (901) 291-2400

## Contact information

- **Practice address:** 7601 SOUTHCREST PKWY, SOUTHAVEN, MS 38671-4739
- **Practice address phone:** (901) 291-2400
- **Mailing address:** 880 GREENLEAF RD, COLDWATER, MS 38618-8133
- **Mailing address phone:** (901) 291-2400

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | MD 11905 | MS | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | MD 16101 | TN | — |

## Other

- **Enumeration date:** 05/24/2005
- **Last updated:** 04/13/2015