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Organization
DIABETES AND ENDOCRINE CENTER OF MS
Active
Organization
DIABETES AND ENDOCRINE CENTER OF MS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRI FEWELL (OFFICE MANAGER)
(601) 292-1228
Entity
Organization
Contact information
Practice address
971 LAKELAND DR, SUITE 450, JACKSON, MS 39216-4643
(601) 948-5158
(601) 326-4265
Mailing address
971 LAKELAND DR, SUITE 450, JACKSON, MS 39216-4643
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
19640
MS
174400000X
Specialist
20965
MS
174400000X
Specialist
21031
MS
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
NULL
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
Other
Enumeration date
11/24/2010
Last updated
05/30/2023
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