Individual
L C TENNIN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
122 E ACADEMY ST, CANTON, MS 39046-4502
(601) 859-8992
(601) 859-5573
Mailing address
122 E ACADEMY ST, CANTON, MS 39046-4502
(601) 859-8992
(601) 859-5573
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
09432
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00011031
—
MS
Enumeration date
08/09/2006
Last updated
04/27/2019
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