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EAR NOSE & THROAT SURGICAL GROUP NPI 1881712057


NPI Information

NPI: 1881712057
Provider Name: EAR NOSE & THROAT SURGICAL GROUP
Classification: Otolaryngology - 207Y00000X
Entity Type: Organization

CLIA Number: 25D0953300

Address:
764 LAKELAND DRIVE
SUITE 200
JACKSON, MS
ZIP 39216
Phone: (601) 982-0611
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EAR NOSE & THROAT SURGICAL GROUP is an otolaryngology in Jackson, 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 SURGICAL GROUP NPI is 1881712057. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

764 LAKELAND DRIVE
SUITE 200
JACKSON, MS
ZIP 39216-617
Phone: (601) 982-0611
Fax: (601) 321-1647

The provider's authorized official is Karen D Alford .
The authorized official title is Cfo Administrator and has the following contact phone number (601) 321-1626.

The CLIA number assigned to this NPI record is 25D0953300 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/27/2007 and was last updated on 8/22/2020.


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
1207Y00000XOtolaryngologyYes

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: 11/14/2023

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