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NPI 1710598339 · Preventive Medicine/Occupational Environmental Medicine Physician · Southaven, MS
Provider details
- NPI number
- 1710598339
- Entity type
- Organization
- Primary specialty
- Preventive Medicine/Occupational Environmental Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jill Patton, Director of Risk Management(704) 936-5546
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
8650 Commerce Dr Ste 100
Southaven, MS 38671-7391
Phone: (662) 342-3700
Approximate (ZIP-level) locationGet directions
Mailing address
4651 Charlotte Park Dr Ste 300
Charlotte, NC 28217-1916
Registry dates
- Enumerated
- 2020-08-17
- Last updated
- 2020-08-17
- Certified
- 2020-08-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.