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EAR NOSE & THROAT PHYSICIANS OF NORTH MISS. P.A. NPI 1861507311


NPI Information

NPI: 1861507311
Provider Name: EAR, NOSE & THROAT PHYSICIANS OF NORTH MISS., P.A.
Classification: Otolaryngology - 207Y00000X
Entity Type: Organization

CLIA Number: 25D1015703

Address:
618 PEGRAM DR
TUPELO, MS
ZIP 38801
Phone: (662) 844-6513
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EAR, NOSE & THROAT PHYSICIANS OF NORTH MISS., P.A. is an otolaryngology in Tupelo, 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. EAR, NOSE & THROAT PHYSICIANS OF NORTH MISS., P.A. NPI is 1861507311. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

618 PEGRAM DR
TUPELO, MS
ZIP 38801-322
Phone: (662) 844-6513
Fax: (662) 844-1113

The provider's authorized official is James Montgomery Berry .
The authorized official title is President and has the following contact phone number (662) 844-6513.

The CLIA number assigned to this NPI record is 25D1015703 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/21/2006 and was last updated on 6/24/2010.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Y00000XOtolaryngologyMISSISSIPPIYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1=========OTHERMISSISSIPPIBLUE CROSS BLUE SHIELD
2CE6078OTHERMISSISSIPPIMEDICARE RAILROAD
309011431MEDICAIDMISSISSIPPI
4C00456MEDICARE ID-TYPE UNSPECIFIEDMISSISSIPPI

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: 4/28/2024

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