Organization
ALWIN MAX JUCHHEIM III, DPM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHY J LYON (OFFICE MANAGER)
(662) 226-3333
Entity
Organization
Contact information
Practice address
1300 SUNSET DR, SUITE P, GRENADA, MS 38901-4086
(662) 226-3333
(662) 226-7722
Mailing address
1300 SUNSET DR, SUITE P, GRENADA, MS 38901-4086
(662) 226-3333
(662) 226-7722
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
80068
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00011116
—
MS
Enumeration date
03/27/2008
Last updated
03/27/2008
Update your record
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