Individual
DR. ROBERT ERVIN TATUM SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
276B NISSAN PKWY, STE 200, CANTON, MS 39046-7032
(601) 859-1929
(601) 859-1926
Mailing address
PO BOX 667, CANTON, MS 39046-0667
(601) 859-1929
(601) 859-1926
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16155
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00120001
—
MS
Enumeration date
01/01/2007
Last updated
03/20/2014
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