Trace Truman Palmer, MD
Individual provider Active NPI Otolaryngology Physician · Tupelo, MS
NPI 1093344699 · NPPES record last updated May 21, 2025
Key facts
- NPI
- 1093344699
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Otolaryngology Physician 207Y00000X
- License
- 35163 (MS)
- Practice address
- 618 Pegram Dr
Tupelo, MS 38801-6322 - Phone
- (662) 844-7656
- Fax
- (662) 823-6942
- NPI assigned
- Apr 6, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Otolaryngology
- Education
- University of Mississippi School of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ear, Nose and Throat Physicians of North Miss., P.a
Practice addresses (Care Compare)
618 Pegram Dr
Tupelo, MS 38801-6322
Phone (601) 844-6513
Hospital & facility affiliations
- North Mississippi Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 1-10 |
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250818000077 | MS | Practitioner - Otolaryngology | 1557788981 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35163 | MS | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ear, Nose & Throat Physicians of North Miss., P.a. | Otolaryngology | Current |
Accepting new patients |
| North Mississippi Medical Center | Current | Accepting new patients | |
| Premier Radiology, Inc | Past |
Accepting new patients |
Locations
618 Pegram Dr
Tupelo, MS 38801
Phone (601) 841-3000
Interoperability endpoints
- tracepalmer@nmhs.medalliesdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Otolaryngology Physician | 207Y00000X | 35163 | MS | Yes |
Addresses
Primary practice location
618 Pegram Dr
Tupelo, MS 38801-6322
Mailing address
618 Pegram Dr
Tupelo, MS 38801-6322
Phone (662) 844-7656
Other providers in Tupelo, MS
- Palm Hands Personal Care, LLC
- Carol Palmer
- Judy Palmer
- Julie Robin Palmer
- Kathryn Howell Palmer
- Petro Palykhata
- Jennifer Pannell
- Katelynn Pannell
- Katlynn Pannell
- Marqueena Pannell
All providers in Tupelo, MS · Otolaryngology Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.