Individual
DR. JOHN C. MUTZIGER I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
14884 HWY 15, DECATUR, MS 39327
(601) 635-2258
(601) 635-2259
Mailing address
PO BOX 2106, MERIDIAN, MS 39302-2106
(601) 703-4282
(601) 703-9283
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10066
MS
207QA0401X
Addiction Medicine (Family Medicine) Physician
10066
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00011490
—
MS
Enumeration date
11/22/2005
Last updated
10/20/2016
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