Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 07336 | MS |
NPI | 1063465060 |
---|---|
Provider Name | Dr. Edwin D. Meeks Ii |
First Address | Columbus, MS 39705-2005 |
Second Address | Columbus, MS 39705-2005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00011109 | (05) | MS |
B-30790 | (02) | MS |