Organization
ROME SHERROD II MD
Active
Other names
TRI-STATE HEALTHCARE FOR WOMEN
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROME SHERROD II MD (OWNER)
(662) 349-9370
Entity
Organization
Contact information
Practice address
7600 AIRWAYS BLVD STE B, SOUTHAVEN, MS 38671-5138
(662) 349-9370
(662) 349-9372
Mailing address
7600 AIRWAYS BLVD STE B, SOUTHAVEN, MS 38671-5138
(662) 349-9370
(662) 349-9372
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0013667
—
MS
01
—
2008964
BLUE CROSS BLUE SHIELD
TN
01
—
427842189
BLUE CROSS BLUE SHIELD MS
MS
Enumeration date
12/17/2007
Last updated
06/10/2013
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