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Individual

SYLVIA WINGO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1551 W GOVERNMENT ST, BRANDON, MS 39042-2408
(601) 825-3163
Mailing address
PO BOX 1509, BRANDON, MS 39043-1509
(601) 825-7280

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
17704
OK
208000000X
Pediatrics Physician
Primary
22598
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05376221
MS
Enumeration date
08/14/2013
Last updated
04/16/2014
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