Individual
JOHN WAYNE CHEATHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1600 22ND AVE, MERIDIAN, MS 39301-3223
(601) 483-5322
(601) 581-2289
Mailing address
703 ALCORN DR STE 109, CORINTH, MS 38834-9302
(662) 293-1175
(662) 293-4323
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18926
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04720872
—
MS
Enumeration date
02/08/2006
Last updated
02/18/2019
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