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General NPI Number Information
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NPI Number | 1750645685
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Entity Type | Individual
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Provider Name | CHANNING C TWYNER MD
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Gender | Male
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Dates
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Enumeration Date | 06/26/2012
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 2500 N STATE ST
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City | JACKSON
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State | MS
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Zip | 39216-4500
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Country | US
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Telephone | 601-815-2005
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Fax |
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Provider Business Mailing Address
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Address Line | 504 CLINTON CENTER DRIVE CBO - SUITE 4300
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City | CLINTON
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State | MS
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Zip | 39056-5610
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Country | US
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Telephone | 601-815-2005
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 35192
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 56753
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 71483
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 25047
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License Number State | MS
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