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General NPI Number Information
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NPI Number | 1346300423
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Entity Type | Organization
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Legal Business Name | AMNUEY M CHIEMPRABHA MD PA
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 05/05/2008
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Provider Practice Location Address
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Address Line | 820 MANGUM AVE
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City | MENDENHALL
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State | MS
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Zip | 39114
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Country | US
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Telephone | 601-847-5066
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Fax | 601-847-0149
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Provider Business Mailing Address
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Address Line | PO BOX 295
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City | MENDENHALL
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State | MS
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Zip | 39114
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Country | US
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Telephone | 601-847-5066
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Fax | 601-847-0149
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Authorized Official
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Title or Position | PRESIDENT
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Name | AMNUEY M CHIEMPRABHA
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Credential | MD
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Telephone | 601-847-5066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 08142
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 08142
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License Number State | MS
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