Healthcare Provider Details

I. General information

NPI: 1326277427
Provider Name (Legal Business Name): MICHAEL WILLIAM KOURY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2009
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 BELK BLVD
OXFORD MS
38655-5242
US

IV. Provider business mailing address

1339 PIERCE AVE
OXFORD MS
38655-4433
US

V. Phone/Fax

Practice location:
  • Phone: 662-636-1000
  • Fax: 662-200-5928
Mailing address:
  • Phone: 662-816-4774
  • Fax: 662-200-5928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number21263
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number21263
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: