Organization
MISSISSIPPI EAR, NOSE AND THROAT SURGICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLARENCE MICHAEL OSBORNE M.D. (PHYSICIAN)
(601) 709-7700
Entity
Organization
Contact information
Practice address
501 MARSHALL ST, SUITE 501, JACKSON, MS 39202-1651
(601) 709-7700
(601) 709-7701
Mailing address
501 MARSHALL ST, SUITE 501, JACKSON, MS 39202-1651
(601) 709-7700
(601) 709-7701
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06420247
—
MS
Enumeration date
02/20/2007
Last updated
07/08/2010
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