Provider Demographics
NPI:1336648781
Name:NORTH MISSISSIPPI ALLERGY AND ASTHMA CENTER PLLC
Entity Type:Organization
Organization Name:NORTH MISSISSIPPI ALLERGY AND ASTHMA CENTER PLLC
Other - Org Name:NORTH MISSISSIPPI ALLERGY AND ASTHMA CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:SHELTON
Authorized Official - Last Name:FINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-620-0688
Mailing Address - Street 1:450 E PRESIDENT AVE
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-5599
Mailing Address - Country:US
Mailing Address - Phone:662-377-4685
Mailing Address - Fax:662-377-2755
Practice Address - Street 1:118 FAIRFIELD DRIVE
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:MS
Practice Address - Zip Code:38652
Practice Address - Country:US
Practice Address - Phone:662-620-0688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH MISSISSIPPI ALLERGY AND ASTHMA CENTER PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-02-12
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty