Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 968-L | MS |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 968-L | MS |
NPI | 1245646702 |
---|---|
Provider Name | Dr. Hamdi Sukkarieh |
First Address | Jackson, MS 39216-4500 |
Second Address | Jackson, MS 39216-4500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2014 |
Last Update Date | 17/06/2020 |