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Organization
NORTHEAST MS INTERNAL MEDICINE PC
Active
Organization
NORTHEAST MS INTERNAL MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAURENCE L DENNIS MD (PRESIDENT)
(662) 340-1138
Entity
Organization
Contact information
Practice address
202 N 1ST ST, SUITE A, BOONEVILLE, MS 38829-2718
(662) 340-1138
(662) 728-5185
Mailing address
202 N 1ST ST, SUITE A, BOONEVILLE, MS 38829-2718
(662) 340-1138
(662) 728-5185
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
12/07/2005
Last updated
06/30/2015
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