Healthcare Provider Details

I. General information

NPI: 1922031616
Provider Name (Legal Business Name): ROBERT JOSEPH CATER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1521 22ND AVE
MERIDIAN MS
39301-4016
US

IV. Provider business mailing address

1521 22ND AVE
MERIDIAN MS
39301-4016
US

V. Phone/Fax

Practice location:
  • Phone: 601-483-9358
  • Fax: 601-483-9664
Mailing address:
  • Phone: 601-483-9358
  • Fax: 601-483-9664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number05967
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: