Individual
DR. MISTY T SHARP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2110 5TH ST N, COLUMBUS, MS 39705-2210
(662) 243-2435
(662) 328-7037
Mailing address
PO BOX 8695, COLUMBUS, MS 39705-0012
(662) 243-2435
(662) 328-7037
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
E4404
AR
207ND0900X
Dermatopathology Physician
Primary
19576
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159885001
—
AR
01
—
5N232
BCBS PPP PROVIDER #
AR
Enumeration date
08/01/2006
Last updated
08/01/2007
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