Organization
STARKVILLE UROLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONACIANA INGRAM (OFFICE MANAGER)
(662) 324-1097
Entity
Organization
Contact information
Practice address
1207 HIGHWAY 182 W STE B, STARKVILLE, MS 39759-9013
(662) 324-1097
(662) 324-2412
Mailing address
1207 HIGHWAY 182 W STE B, STARKVILLE, MS 39759-9013
(662) 324-1097
(662) 324-2412
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
17324
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00124405
—
MS
Enumeration date
06/15/2007
Last updated
08/21/2020
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