Organization
EAR, NOSE AND THROAT & FACIAL PLASTIC SURGERY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES EDWIN GUICE III M.D. (PRESIDENT)
(601) 268-5131
Entity
Organization
Contact information
Practice address
107 MILLSAPS DR, HATTIESBURG, MS 39402-1348
(601) 268-5131
(601) 268-5138
Mailing address
PO BOX 17829, HATTIESBURG, MS 39404-7829
(601) 268-5131
(601) 268-5138
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09011650
—
MS
Enumeration date
11/22/2006
Last updated
02/04/2010
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