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Organization

CENTRAL MISSISSIPPI FOOT SPECIALIST, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LAWRENCE EDWARD TAMBURINO D.P.M, (DOCTOR OF PODIATRIC MEDICINE)
(601) 824-4700
Entity
Organization

Contact information

Practice address
103 SERVICE DR, BRANDON, MS 39042-2401
(601) 824-4700
(601) 824-4800
Mailing address
103 SERVICE DR, BRANDON, MS 39042-2401
(601) 824-4700
(601) 824-4800

Taxonomy

Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
80160
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09015930
MS
Enumeration date
06/26/2007
Last updated
04/27/2015
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