Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 24312 | MS |
NPI | 1093032542 |
---|---|
Provider Name | Matthew Arrington Vanlandingham |
First Address | Flowood, MS 39232-9019 |
Second Address | Flowood, MS 39232-9019 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2010 |
Last Update Date | 26/06/2016 |