EAR NOSE AND THROAT SURGICAL GROUP

JACKSON, MS
NPI1699810069
Entity TypeOrganization
Authorized ContactMICKEY P WALLACE
Physician
601-898-7000
Organization Subpart ?No
Primary Taxonomy174400000X Specialist
(Licence: MS  08819)
Enumeration Date2007-02-21
Last Update Date2011-08-10
Business Address
EAR NOSE AND THROAT SURGICAL GROUP
970 LAKELAND DR STE 40
JACKSON, MS 39216-4640
Phone number: 601-200-4850
Mailing Address
EAR NOSE AND THROAT SURGICAL GROUP
PO BOX 23666
JACKSON, MS 39225
Phone number: 601-200-4850
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