ENDOCRINE & METABOLIC DISORDERS INSTITUTE PLLC - NPI NUMBER 1457322661

Summary

Provider Name: ENDOCRINE & METABOLIC DISORDERS INSTITUTE PLLC

NPI Number: 1457322661

Clasification: Internal Medicine (207RE0101X)

Specialization: Endocrinology, Diabetes & Metabolism

Address:
910 MARY VANCE DRIVE
TUPELO, MS
ZIP 38801

Phone Number: (662) 377-6275



Detailed Information

ENDOCRINE & METABOLIC DISORDERS INSTITUTE PLLC is an endocrinology, diabetes & metabolism internist in Tupelo, MS. The provider is an internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. The assigned NPI number for this provider is 1457322661 and is registered as an organization entity type and is a single specialty group.

The provider's business address is:

910 MARY VANCE DRIVE
TUPELO, MS
ZIP 38801-000
Phone: (662) 377-6275
Fax: (662) 377-6299

The provider's authorized official is Jayant Dey .
The authorized official title is Md and has the following contact phone number (662) 377-6275.

The enumeration date for this NPI number is 1/27/2006 and was last updated on 4/26/2012.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism Yes

NPI Record

No. Field Name Field Value
1 NPI 1457322661
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name ENDOCRINE & METABOLIC DISORDERS INSTITUTE PLLC
5 Provider First Line Business Practice Location Address 910 MARY VANCE DRIVE
6 Provider Business Practice Location Address City Name TUPELO
7 Provider Business Practice Location Address State Name MS
8 Provider Business Practice Location Address Postal Code 388010000
9 Provider Business Practice Location Address Country Code If outside U S US
10 Provider Business Practice Location Address Telephone Number 6623776275
11 Provider Business Practice Location Address Fax Number 6623776299
12 Provider Enumeration Date 1/27/2006
13 Last Update Date 4/26/2012
14 Authorized Official Last Name DEY
15 Authorized Official First Name JAYANT
16 Authorized Official Title or Position MD
17 Authorized Official Telephone Number 6623776275
18 Healthcare Provider Taxonomy Code 1 207RE0101X
19 Healthcare Provider Primary Taxonomy Switch 1 Y
20 Is Organization Subpart N
21 Authorized Official Credential Text MD
22 Healthcare Provider Taxonomy Group 1 193400000X SINGLE SPECIALTY GROUP

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This page was last updated on: 10/12/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.