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Organization

JACKSON EAR CLINIC PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KATHY PEEPLES (OFFICE MANAGER)
(601) 981-2825
Entity
Organization

Contact information

Practice address
290 E LAYFAIR DR, FLOWOOD, MS 39232-9526
(601) 981-2825
(601) 981-2827
Mailing address
290 E LAYFAIR DR, FLOWOOD, MS 39232-9526
(601) 981-2825
(601) 981-2827

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
11369
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04586854
MS
Enumeration date
04/25/2007
Last updated
08/12/2020
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