NORTH MISSISSIPPI ORAL & MAXILLOFACIAL SURGERY ASSOCIATES, PA (NPI# 1831104793) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831104793 |
| Entity Type | Organization |
| Organization Name | NORTH MISSISSIPPI ORAL & MAXILLOFACIAL SURGERY ASSOCIATES, PA |
| Practice Address |
1043 S Madison St Tupelo MS 38801-6309 |
| Practice Telephone | 6628428200 |
| Practice Fax Number | 6628443157 |
| Mailing Telephone | 6628428200 |
| Mailing Fax Number | 6628443157 |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. KAREN LYNN COSTELLO (OFFICE MANAGER) |
| Authorized Official Telephone | 6628428200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0106X |
Dentist Specialization: Oral and Maxillofacial Pathology |
MS162174 | MS | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00063290 | 05 | |
| MS | 0660076 | 05 | |
| MS | 00660372 | 05 | |
| MS | 05021312 | 05 |
| Street Address |
1043 S MADISON ST |
| City | TUPELO |
| State | MS |
| Zip Code | 38801-6309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295932473 | Steven Bradford Roberts | Dentist | 1043 S Madison St, Tupelo, MS 38801-6309 | 2007-06-29 |
| 1689680266 | James Leland Chrisman | Dentist | 1043 S Madison St, Tupelo, MS 38801-6309 | 2006-08-01 |
| 1174539753 | William F. West | Dentist | 1043 S Madison St, Tupelo, MS 38801-6309 | 2006-08-01 |
| 1730194614 | Charles W. Wikle | Dentist | 1043 S Madison St, Tupelo, MS 38801-6309 | 2006-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194339275 | Friendship, LLC | Pharmacy | 4123 W Main St, Tupelo, MS 38801 | 2020-09-04 |
| 1003443458 | Nicole Sherice Taylor | Nurse Practitioner | 845 South Gloster Street, Tupelo, MS 38801 | 2020-03-25 |
| 1821556838 | Wilco Healthcare of North Mississippi, Pllc | Point of Service | 1514 Co Rd 41, Tupelo, MS 38801 | 2019-03-08 |
| 1821565235 | Stephanie K Cagle | Nurse Practitioner | 218 S Thomas St Ste 120-121, Tupelo, MS 38801 | 2018-10-24 |
| 1073092326 | Lauren Parrish | Nurse Practitioner | 1573 Medical Park Circle, Tupelo, MS 38801 | 2018-08-08 |
| 1467948687 | North Mississippi Medcial Center, Inc. | Nurse Practitioner | 990 S Madison St Ste 2, Tupelo, MS 38801 | 2018-07-11 |
| 1043700933 | Hooks Diabetes & Medicine Clinic | Non-Pharmacy Dispensing Site | 2610 Traceland Drive, Ste A, Tupelo, MS 38801 | 2018-05-16 |
| 1073035903 | Annette C Riddle | Counselor | 1004 Eisenhower Drive, Tupelo, MS 38801 | 2017-07-12 |
| 1548709678 | Jaime Summers | Nurse Practitioner | 2780 West Jackson St, Tupelo, MS 38801 | 2017-02-22 |
| 1073975611 | Heath Bryan Coleman, Dds of Mississippi II, Pllc | Dentist | 1168 Cross Creek Drive, Tupelo, MS 38801 | 2016-03-23 |
| Find all providers in zip 38801 | ||||
| Taxonomy Code | 1223P0106X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Pathology |
| The specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral and maxillofacial pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730273442 | Robert Charles Zalme | Dentist | 81 Mdg/sgsc, 301 Fisher Street, Biloxi, MS 39534 | 2006-10-03 |
| 1386758829 | Tina Rushing Woods | Dentist | 2500 N. State Street, Ummc School of Dentistrydept. Omfs & Pathology, D215-03, Jackson, MS 39216-4505 | 2006-08-19 |
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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.