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General NPI Number Information
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NPI Number | 1386432961
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Entity Type | Organization
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Legal Business Name | MISSISSIPPI OTOLARYNGOLOGY HEAD AND NECK SURGERY
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Dates
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Enumeration Date | 04/25/2025
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 694 BELLE TERRE BLVD
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City | LA PLACE
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State | LA
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Zip | 70068-1620
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Country | US
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Telephone | 504-905-7033
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Fax |
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Provider Business Mailing Address
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Address Line | 345 E LIVINGSTON PL
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City | METAIRIE
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State | LA
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Zip | 70005-3943
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Country | US
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Telephone | 504-905-7033
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GREGORY PIPPIN
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Credential | MD
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Telephone | 504-905-7033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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