Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 16678 | MS |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 16678 | MS |
NPI | 1730295064 |
---|---|
Provider Name | Michael Lynn Peery |
First Address | Corinth, MS 38835-2040 |
Second Address | Corinth, MS 38834-9321 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 14/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0120582 | (05) | MS |
G27692 | (02) | MS |