Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 17632 | MS |
NPI | 1073501458 |
---|---|
Provider Name | Peter D. Mcarthur |
First Address | Cleveland, MS 38732-2830 |
Second Address | Cleveland, MS 38732-2830 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2005 |
Last Update Date | 01/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00126255 | (05) | MS |
1769681 | (05) | LA |
H69321 | (02) | MS |