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BROOKHAVEN EAR NOSE & THROAT PA NPI 1225152580


NPI Information

NPI: 1225152580
Provider Name: BROOKHAVEN EAR, NOSE & THROAT PA

Other Name: MISSISSIPPI SINUS CENTER

Classification: Otolaryngology - 207Y00000X
Entity Type: Organization

CLIA Number: 25D1076717

Address:
201 S RAILROAD AVE
BROOKHAVEN, MS
ZIP 39601
Phone: (601) 835-0077
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BROOKHAVEN EAR, NOSE & THROAT PA is an otolaryngology in Brookhaven, MS. The provider is an otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. BROOKHAVEN EAR, NOSE & THROAT PA NPI is 1225152580. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Mississippi Sinus Center.

The provider's business location address is:

201 S RAILROAD AVE
BROOKHAVEN, MS
ZIP 39601-331
Phone: (601) 835-0077
Fax: (601) 835-0095

The provider's authorized official is Ryan Corey Case .
The authorized official title is President and has the following contact phone number (601) 835-0077.

The CLIA number assigned to this NPI record is 25D1076717 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/19/2007 and was last updated on 1/27/2016.


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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Y00000XOtolaryngology10309MISSISSIPPIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
108837378MEDICAIDMISSISSIPPI
2C04608MEDICARE PINMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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