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General NPI Number Information
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NPI Number | 1265486450
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Entity Type | Individual
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Provider Name | EMMANUEL KPABITEY M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 10/05/2018
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Provider Practice Location Address
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Address Line | 110 YAZOO AVE STE 121
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City | CLARKSDALE
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State | MS
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Zip | 38614-4397
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Country | US
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Telephone | 666-592-5052
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Fax | 662-592-5494
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Provider Business Mailing Address
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Address Line | 110 YAZOO AVE STE 121
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City | CLARKSDALE
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State | MS
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Zip | 38614-4397
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Country | US
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Telephone |
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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 | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | 16167
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License Number State | MS
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