Mid South Otolaryngology Associates P.C.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

04813 Issued in MS

Legal business name

MID SOUTH OTOLARYNGOLOGY ASSOCIATES P.C.

Practice address

6890 Elmore Rd
Suite 2
Southaven, MS 38671-9673

Phone

(662) 349-4250

Fax

(662) 349-4249

NPI assigned

Dec 6, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Robert Moore Fisher, MD

Title

Owner

Phone

(662) 349-4250

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287705600000",
    "number": "1467511691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1167",
            "address_2": "6890 ELMORE RD STE 2",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "38671",
            "telephone_number": "662-349-4250",
            "fax_number": "662-349-4249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6890 ELMORE RD",
            "address_2": "SUITE 2",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386719673",
            "telephone_number": "662-349-4250",
            "fax_number": "662-349-4249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID SOUTH OTOLARYNGOLOGY ASSOCIATES P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2010-10-22",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "MOORE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-349-4250",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "MS",
            "license": "04813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00018019",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DB8666",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timothy J Micek, M.D.
• Michael E Foster MD PC
• Michael E Steuer MD PC
• Micheal G Cook OD PC (eyear optical)
• Anna Kathryn Michell, COTA/L
• Mid-Delta Hospice North Inc (Bristol Hospice - Southaven)
• Mid-South Anesthesia Consultants, PLLC
• Mid-South Imaging Center LLC
• Mid-South Orthopedic Hospitalists LLC
• Lindsey Nicole Middleton, NP

• Otolaryngology Physician in Southaven, MS
• Providers in Southaven, MS by specialty
• Otolaryngology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.