Organization
ELITE MEDICAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANNE DYE HAIRE D.O. (OWNER/PHYSICIAN)
(662) 205-4652
Entity
Organization
Contact information
Practice address
2633 TRACELAND DR, TUPELO, MS 38801-4238
(662) 205-4652
(662) 205-4651
Mailing address
PO BOX 2484, TUPELO, MS 38803-2484
(662) 205-4652
(662) 205-4651
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
16935
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00126275
—
MS
Enumeration date
06/08/2011
Last updated
10/22/2013
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