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Individual

DONALD PERRIN ROTEN JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
500 W BANKHEAD ST, NEW ALBANY, MS 38652-3101
(662) 534-7474
(662) 534-7100
Mailing address
PO BOX 405827, ATLANTA, GA 30384-5800

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
16453
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09733845
MS
Enumeration date
05/26/2006
Last updated
10/24/2016
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