Organization
AMNUEY M CHIEMPRABHA MD PA
Active
Other names
Doctors Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
AMNUEY M CHIEMPRABHA MD (PRESIDENT)
(601) 847-5066
Entity
Organization
Contact information
Practice address
820 MANGUM AVE, MENDENHALL, MS 39114
(601) 847-5066
(601) 847-0149
Mailing address
PO BOX 295, MENDENHALL, MS 39114
(601) 847-5066
(601) 847-0149
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
08142
MS
208600000X
Surgery Physician
08142
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01722227
—
MS
Enumeration date
12/11/2006
Last updated
05/05/2008
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