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General NPI Number Information
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NPI Number | 1487800520
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Entity Type | Organization
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Legal Business Name | MISSISSIPPI VEIN INSTITUTE
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Dates
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Enumeration Date | 08/08/2008
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 111 FOUNTAINS BLVD
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City | MADISON
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State | MS
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Zip | 39110-6344
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Country | US
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Telephone | 601-707-7026
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Fax | 601-707-7054
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Provider Business Mailing Address
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Address Line | 111 FOUNTAINS BLVD
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City | MADISON
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State | MS
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Zip | 39110-6344
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Country | US
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Telephone | 601-707-7026
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Fax | 601-707-7054
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN MICHAEL MANNING
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Credential | M.D.
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Telephone | 601-927-8176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 202K00000X
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Taxonomy Name | Phlebology Physician
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License Number |
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License Number State |
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