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Organization

DIABETES AND ENDOCRINE CENTER OF MS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TERRI FEWELL (OFFICE MANAGER)
(601) 292-1228
Entity
Organization

Contact information

Practice address
971 LAKELAND DR, SUITE 450, JACKSON, MS 39216-4643
(601) 948-5158
(601) 326-4265
Mailing address
971 LAKELAND DR, SUITE 450, JACKSON, MS 39216-4643

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
19640
MS
174400000X
Specialist
20965
MS
174400000X
Specialist
21031
MS
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary

Other

Enumeration date
11/24/2010
Last updated
05/30/2023
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