Organization
TUPELO ORTHOPEDIC CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RHONDA BLACK (INSURANCE CLERK/CODER)
(662) 844-5330
Entity
Organization
Contact information
Practice address
808 GARFIELD ST, TUPELO, MS 38801-5749
(662) 844-5330
(662) 841-2962
Mailing address
PO BOX 1506, TUPELO, MS 38802-1506
(662) 844-5330
(662) 841-2962
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9011365
—
MS
Enumeration date
07/18/2006
Last updated
08/14/2012
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