Individual
IAN M WINDMILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2500 N STATE ST, DEPARTMENT OF OTOLARYNGOLOGY, JACKSON, MS 39216-4500
(601) 984-5160
(601) 815-6985
Mailing address
2500 N STATE ST, DEPARTMENT OF OTOLARYNGOLOGY, JACKSON, MS 39216-4500
(601) 984-5160
(601) 815-6985
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
0100
KY
231H00000X
Audiologist
Primary
A3324
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01531216
—
MS
05
—
100345580A
—
IN
01
—
1085858
PASSPORT
KY
05
—
70001003
—
KY
Enumeration date
01/24/2006
Last updated
01/31/2014
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