EAR,NOSE & THROAT SURGICAL CLINIC OF SOUTH CENTRAL MS (NPI# 1033312772) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033312772 |
| Entity Type | Organization |
| Organization Name | EAR,NOSE & THROAT SURGICAL CLINIC OF SOUTH CENTRAL MS |
| Practice Address |
306 S 12th Ave Laurel MS 39440-4327 |
| Practice Telephone | 6016499706 |
| Practice Fax Number | 6016499708 |
| Mailing Telephone | 6016499706 |
| Mailing Fax Number | 6016499708 |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2008-05-21 |
| Authorized Official Name | DR. CARL WAYNE STEVENS II (PRESIDENT) |
| Authorized Official Telephone | 0616499706 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
15762 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09301826 | 05 |
| Street Address |
306 S 12TH AVE |
| City | LAUREL |
| State | MS |
| Zip Code | 39440-4327 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306323159 | Tender Loving Care Homecare LLC | Homemaker | 509 Central Ave Ste 224, Laurel, MS 39440 | 2018-07-24 |
| 1669837910 | Laurel Dental Properties | Dentist | 1925 Pine Belt Drive, Laurel, MS 39440 | 2015-12-30 |
| 1215282991 | South Central Regional Medical Center | Clinic/Center | 525 Wayne Drive, Laurel, MS 39440 | 2012-07-18 |
| 1568721215 | Terry Ratcliff Perkins | Counselor | 5192 Hwy 11 North, Laurel, MS 39440 | 2012-05-15 |
| 1437453057 | Alexander Milne Home for Women | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 616 East 19th Street, Laurel, MS 39440 | 2010-12-23 |
| 1710135629 | Jeffrey R. Moffett | Nurse Practitioner | 3115 Audubon Dr, Laurel, MS 39440 | 2008-09-04 |
| 1003096785 | Family Health Center, Inc | Obstetrics & Gynecology | 103 S. 12th Avenue, Laurel, MS 39440 | 2007-11-09 |
| 1669672143 | Laurel Urology Clinic Pa | Urology | 304 S 10th Ave, Laurel, MS 39440 | 2007-07-23 |
| 1093912370 | Tanweer Hussain Majid | Surgery | 1007 Jefferson Street, Laurel, MS 39440 | 2007-06-29 |
| 1780889923 | Hattiesburg Eye Clinic, Pa | Ophthalmology | 1431 North 10th St, Suite 1, Laurel, MS 39440 | 2007-06-18 |
| Find all providers in zip 39440 | ||||
| Taxonomy Code | 207YX0905X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otolaryngology/Facial Plastic Surgery |
| An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184165102 | Sinus and Allergy Institute Pllc | Otolaryngology | 1115 Highland Colony Parkway, Suite C, Ridgeland, MS 39157 | 2017-03-09 |
| 1881769032 | Ear, Nose and Throat & Facial Plastic Surgery, P.a. | Otolaryngology | 107 Millsaps Dr, Hattiesburg, MS 39402-1348 | 2006-11-22 |
| 1336238443 | Cole Facial Plastic Surgery | Otolaryngology | 1030 N Flowood Dr, Ste A, Jackson, MS 39232-9532 | 2006-10-12 |
| 1134239171 | Peter J Casano | Otolaryngology | 1038 River Oaks Dr, Flowood, MS 39232 | 2006-08-30 |
| 1437269479 | Charles Ron Cannon | Otolaryngology | 1038 River Oaks Dr, Flowood, MS 39232 | 2006-08-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.