Individual
KENNETH WOLFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
844 S MADISON ST, TUPELO, MS 38801-4904
(662) 377-5400
(662) 377-5415
Mailing address
844 S MADISON ST, TUPELO, MS 38801-4904
(662) 377-5400
(662) 377-5415
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16452
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00124238
—
MS
Enumeration date
04/26/2006
Last updated
02/18/2011
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