Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 19214 | MS |
N | 111NI0900X | Internist | 19214 | MS |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 19414 | MS |
NPI | 1053474577 |
---|---|
Provider Name | Christy Tucker Oswalt |
First Address | Tupelo, MS 38801-9631 |
Second Address | Tupelo, MS 38801-4352 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2006 |
Last Update Date | 03/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04971328 | (05) | MS |