Individual
DR. ESWARA KUMAR MUNDRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 NORTH STATE STREET, UNIVERSITY OF MISSISSIPPI MEDICAL CENTER RADIATION ONCO, JACKSON, MS 39216-4505
(601) 815-6886
(601) 815-6876
Mailing address
2500 NORTH STATE STREET, UNIVERSITY OF MISSISSIPPI MEDICAL CENTER, JACKSON, MS 39216-4505
(601) 815-6886
(601) 815-6876
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
947-L
MS
282N00000X
General Acute Care Hospital
947-L
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07083393
—
MS
Enumeration date
07/28/2015
Last updated
01/29/2019
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