EAR NOSE AND THROAT & FACIAL PLASTIC SURGERY P.A. NPI 1881769032

NPI Information

EAR, NOSE AND THROAT & FACIAL PLASTIC SURGERY, P.A. is an otolaryngology/facial plastic surgery otolaryngology in Hattiesburg, MS. The provider is an otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. EAR, NOSE AND THROAT & FACIAL PLASTIC SURGERY, P.A. NPI is 1881769032. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

107 MILLSAPS DR
HATTIESBURG, MS
ZIP 39402-348
Phone: (601) 268-5131
Fax: (601) 268-5138

The provider's authorized official is Charles Edwin Guice .
The authorized official title is President and has the following contact phone number (601) 268-5131.

The CLIA number assigned to this NPI record is 25D1057017 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/22/2006 and was last updated on 2/4/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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