Ear Nose and Throat Surgical Group
Ear Nose and Throat Surgical Group is a Specialist in Jackson, Mississippi. Licensed in Mississippi. Registered with an NPI since 2007.
- Licensed in
- MS
- In the registry since
- 2007
Practice location Address checks out
970 Lakeland Dr Ste 40Jackson, MS 39216-4640
Phone: (601) 200-4850
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Specialist (primary) | Taxonomy 174400000X · Licence 08819 (MS) |
|---|
Record details
| NPI number | 1699810069 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Mickey Wallace — Physician · (601) 898-7000 |
| NPI enumerated | February 21, 2007 |
| Last updated in NPPES | August 10, 2011 |
| Mailing address | Po Box 23666, Jackson, MS 39225 |
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Dr. Ruth Kellum Fredericks, MD
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-
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Guy T. Vise Jr , MD
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