# L.C. TENNIN, JR M.D., P.A.

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

## Provider details

- **NPI number:** 1598908774
- **Authorized official:** DR. LC TENNIN JR. (ADMINISTRATIVE PRESIDENT)
- **Authorized official phone:** (601) 214-5998

## Contact information

- **Practice address:** 122 E ACADEMY ST, CANTON, MS 39046-4502
- **Practice address phone:** (601) 859-8992
- **Practice address fax:** (601) 859-5573
- **Mailing address:** PO BOX 647, CANTON, MS 39046-0647

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/17/2009
- **Last updated:** 04/27/2019