Provider Demographics
NPI:1457322661
Name:ENDOCRINE & METABOLIC DISORDERS INSTITUTE PLLC
Entity Type:Organization
Organization Name:ENDOCRINE & METABOLIC DISORDERS INSTITUTE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:JAYANT
Authorized Official - Middle Name:
Authorized Official - Last Name:DEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:662-377-6275
Mailing Address - Street 1:910 MARY VANCE DRIVE
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-0000
Mailing Address - Country:US
Mailing Address - Phone:662-377-6275
Mailing Address - Fax:662-377-6299
Practice Address - Street 1:910 MARY VANCE DRIVE
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-0000
Practice Address - Country:US
Practice Address - Phone:662-377-6275
Practice Address - Fax:662-377-6299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-27
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty