Pummer, Terry Lee

Pummer, Terry Lee is an individual health care provider with primary practice located at 960 Avent Dr Suite 100A, Grenada MS 38901-5230. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Pummer, Terry Lee can be contacted via phone (662) 227-7444.

Contact Information

Primary practice address
960 Avent Dr Suite 100A Grenada MS 38901-5230
Fax: (662) 227-7443
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X OS012759 Pennsylvania
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 21836 Mississippi

Profile Details

NPI number 1528056637
LBN Legal business name Pummer, Terry Lee
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2005
Last updated Oct 22nd, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528056637 NPPES
Mississippi MEDICAID 00059747
Mississippi MEDICAID 101343001

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