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Organization

NORTHWEST MISSISSIPPI OTOLARYNGOLOGY HEAD & NECK SURGERY, LLC

Active
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Organization

NORTHWEST MISSISSIPPI OTOLARYNGOLOGY HEAD & NECK SURGERY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEFFREY JORDAN CUNNINGHAM M.D. (OWNER)
(662) 349-7676
Entity
Organization

Contact information

Practice address
7165 GETWELL RD, BUILDING H, SUITE 1, SOUTHAVEN, MS 38672-9618
(662) 349-7676
(662) 349-7679
Mailing address
7165 GETWELL RD, BUILDING H, SUITE 1, SOUTHAVEN, MS 38672-9618
(662) 349-7676
(662) 349-7679

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary

Other

Enumeration date
06/15/2010
Last updated
06/15/2010
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