Mississippi Ear, Nose and Throat Surgical Associates

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

MISSISSIPPI EAR, NOSE AND THROAT SURGICAL ASSOCIATES

Practice address

501 Marshall St
Suite 501
Jackson, MS 39202-1651

Phone

(601) 709-7700

Fax

(601) 709-7701

NPI assigned

Feb 20, 2007

Last updated

Jul 8, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Clarence Michael Osborne, M.D.NPI 1548356983

Title

Physician

Phone

(601) 709-7700

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Mississippi Ear Nose and Throat Surgical Associates

  • Otolaryngology Physician
  • Kosciusko, MS
  • NPI 1245504026

  O20040825000904

  Same enrollment
• Mississippi Ear, Nose and Throat Surgical Associates, P.C.

  • Otolaryngology Physician
  • Madison, MS
  • NPI 1821204736

  O20040825000904

  Same enrollment
• Mississippi Ear, Nose and Throat Surgical Associates, PC

  • Specialist
  • Flowood, MS
  • NPI 1679905210

  O20040825000904

  Same enrollment

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Clarence Michael Osborne, MD

  • Otolaryngology Physician
  • Flowood, MS
  • NPI 1548356983
  Authorized official Same address or phone
• Benjamin Thomas Jeffcoat, MD

  • Otolaryngology Physician
  • Flowood, MS
  • NPI 1679792295
  NPD
• Stephen Frederick Lee, MD

  • Otolaryngology Physician
  • Flowood, MS
  • NPI 1255427696
  NPD

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278547200000",
    "number": "1679617773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 MARSHALL ST",
            "address_2": "SUITE 501",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392021651",
            "telephone_number": "601-709-7700",
            "fax_number": "601-709-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 MARSHALL ST",
            "address_2": "SUITE 501",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392021651",
            "telephone_number": "601-709-7700",
            "fax_number": "601-709-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI EAR, NOSE AND THROAT SURGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2010-07-08",
        "status": "A",
        "authorized_official_last_name": "OSBORNE",
        "authorized_official_first_name": "CLARENCE",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "601-709-7700",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06420247",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mississippi CVS Pharmacy, L.L.C. (CVS Pharmacy #04997)
• Mississippi CVS Pharmacy, L.L.C. (CVS Pharmacy # 05756)
• Mississippi Dental Center of Jackson LLC
• Mississippi Department of Rehabilitaion Services
• Mississippi Department of Rehabilitaion SVS
• Mississippi Em-I Medical Services
• Mississippi Em-I Medical Services PC
• Mississippi Emergency Physician Services, LLC
• Mississippi Eye Care Associates of Jackson, PLLC
• Mississippi Eyecare Associates of Jackson, PLLC.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.