Organization

Desoto Ear, Nose &throat

Otolaryngology Physician in Olive Branch, MS(View on Map)

Legal Business Name

Desoto Ear, Nose &throat

NPI Number

1477644045

NPI Type

Organization

Enumeration Date

09/27/2006

Specialties

(Taxonomies)

Code

207Y00000X

Primary Taxonomy

Yes

Contact
Information

Purpose

Mailing
Location

Address

7164 HACKS CROSS RD STE 106
7164 HACKS CROSS RD STE 106

City

Olive Branch
Olive Branch

State

MS
MS

Postal Code

38654-3919
38654-3919

Country

US
US

Telephone Number

(662) 895-6455
(662) 895-6455

Authorized Official

Name

Greene Colvin

Title or Position

OWNER

Telephone Number

(662) 895-6455

Identifiers

Identifier

09016063

Identifier State

MS

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 06/09/2020

Provider Address