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General NPI Number Information
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NPI Number | 1972150084
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Entity Type | Organization
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Legal Business Name | WOUND MANAGEMENT SPECIALISTS, LLC
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Dates
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Enumeration Date | 08/22/2019
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 120 STONE CREEK BLVD STE 300
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City | FLOWOOD
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State | MS
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Zip | 39232-8211
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Country | US
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Telephone | 769-243-6141
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Fax | 601-510-1665
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Provider Business Mailing Address
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Address Line | 778 LIBERTY RD
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City | FLOWOOD
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State | MS
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Zip | 39232-9321
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Country | US
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Telephone | 769-243-6141
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Fax | 601-510-1665
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Authorized Official
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Title or Position | CHIEF HUMAN RESOURCE OFFICER
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Name | LACHELLE GRIFFIN
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Credential |
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Telephone | 769-208-4437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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