Individual
JEFF JORDAN CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7165 GETWELL RD, BLDG H, SUITE 1, SOUTHAVEN, MS 38672-9618
(662) 349-7676
(662) 349-7679
Mailing address
7165 GETWELL RD, BLDG H, SUITE 1, SOUTHAVEN, MS 38672-9618
(662) 349-7676
(662) 349-7679
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
20122
MS
207Y00000X
Otolaryngology Physician
43312
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09123759
—
MS
Enumeration date
01/02/2008
Last updated
03/09/2016
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