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Organization

UROLOGY GROUP PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEBORAH A EDDLESTONE (CONSULTANT)
(901) 271-2272
Entity
Organization

Contact information

Practice address
401 SOUTHCREST CIR, SUITE 201, SOUTHAVEN, MS 38671
(662) 349-4329
Mailing address
401 SOUTHCREST CIR, SUITE 201, SOUTHAVEN, MS 38671-6726
(662) 349-4329

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09070511
MS
Enumeration date
05/29/2008
Last updated
08/29/2018
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