Organization
L.C. TENNIN, JR M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LC TENNIN JR. (ADMINISTRATIVE PRESIDENT)
(601) 214-5998
Entity
Organization
Contact information
Practice address
122 E ACADEMY ST, CANTON, MS 39046-4502
(601) 859-8992
(601) 859-5573
Mailing address
PO BOX 647, CANTON, MS 39046-0647
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
04/17/2009
Last updated
04/27/2019
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