Organization
EAR, NOSE & THROAT PHYSICIANS OF NORTH MISS., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES MONTGOMERY BERRY M.D. (PRESIDENT)
(662) 844-6513
Entity
Organization
Contact information
Practice address
618 PEGRAM DR, TUPELO, MS 38801-6322
(662) 844-6513
(662) 844-1113
Mailing address
PO BOX 2180, TUPELO, MS 38803-2180
(662) 844-6513
(662) 844-1113
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09011431
—
MS
01
—
CE6078
MEDICARE RAILROAD
MS
Enumeration date
08/21/2006
Last updated
06/24/2010
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