Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 17595 | MS |
NPI | 1013917103 |
---|---|
Provider Name | Dr. Jon T Posey |
First Address | Tupelo, MS 38802-0829 |
Second Address | Tupelo, MS 38801-4600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2005 |
Last Update Date | 11/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00126340 | (05) | MS |
009932483 | (05) | AL |
H67717 | (02) |