Organization
CUNNINGHAM PHYSICAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK L CUNNINGHAM MD (OWNER)
(901) 291-2400
Entity
Organization
Contact information
Practice address
7601 SOUTHCREST PKWY, SOUTHAVEN, MS 38671-4739
(901) 291-2400
Mailing address
880 GREENLEAF RD, COLDWATER, MS 38618-8133
(901) 291-2400
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD 11905
MS
208100000X
Physical Medicine & Rehabilitation Physician
MD 16101
TN
Other
Enumeration date
05/24/2005
Last updated
04/13/2015
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