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General NPI Number Information
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NPI Number | 1255963609
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Entity Type | Individual
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Provider Name | JOHN DENNIS NOWELL
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Gender | Male
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Dates
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Enumeration Date | 02/04/2020
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Last Update Date | 02/04/2020
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Provider Practice Location Address
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Address Line | 406 N BIERDEMAN RD
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City | PEARL
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State | MS
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Zip | 39208-4616
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Country | US
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Telephone | 601-933-0038
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 97172
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City | PEARL
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State | MS
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Zip | 39288-7172
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Country | US
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Telephone | 601-933-0038
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | HA0377
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License Number State | MS
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