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EAR NOSE AND THROAT SURGICAL GROUP
NPI 1699810069
Specialist in Jackson, MS

Active since February 21, 2007
970 LAKELAND DR STE 40, JACKSON, MS 39216(601) 200-4850 Get Directions Write a Review

NPPES record last updated: August 10, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Ear Nose And Throat Surgical Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EAR NOSE AND THROAT SURGICAL GROUP (NPI 1699810069) is a healthcare organization registered as a specialist in Jackson, Mississippi and active in the NPI registry since February 2007. The organization lists Mickey P Wallace, Physician, as its authorized official.

NPPES Registry Identity

NPI1699810069
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameEAR NOSE AND THROAT SURGICAL GROUP
Location Address970 LAKELAND DR STE 40Jackson, MS 39216-4640
Mailing AddressPo Box 23666Jackson, MS 39225 · (601) 200-4850 · Fax (601) 200-4838
Phone(601) 200-4850
Organization SubpartNo
Authorized OfficialMickey P WallacePhysician · (601) 898-7000
Enumeration DateFebruary 21, 2007
Last NPPES UpdateAugust 10, 2011
✔ NPI 1699810069 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in MS · 08819
Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

970 LAKELAND DR STE 40, Jackson, MS 39216
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Other Identifiers 2

Medicaid04387064MS
Medicare PIN302I046365MS

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JESS CLIFTON ROBERTS M.D.
Otolaryngology
970 LAKELAND DR STE 40
JACKSON, MS 39216
Hinds County (601) 200-4850
ALICIA WELLS
Audiologist
970 LAKELAND DR STE 40
JACKSON, MS 39216
Hinds County (601) 200-4850
BRYAN MCRAE CLAY MD
Otolaryngology
970 LAKELAND DR STE 40
JACKSON, MS 39216
Hinds County (601) 200-4580
LISA SPENCER
Audiologist
970 LAKELAND DR STE 40
JACKSON, MS 39216
Hinds County (601) 200-4850
JANICE BRADSHAW
Audiologist
970 LAKELAND DR STE 40
JACKSON, MS 39216
Hinds County (601) 200-4850
KYLE FORD GORDON MD
Otolaryngology
970 LAKELAND DR STE 40
JACKSON, MS 39216
Hinds County (601) 200-4850

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ear Nose And Throat Surgical Group's NPI number?

The NPI number for Ear Nose And Throat Surgical Group is 1699810069. It was assigned to this organization in the NPPES registry on February 21, 2007.

Where is Ear Nose And Throat Surgical Group located?

Ear Nose And Throat Surgical Group is located at 970 Lakeland Dr Ste 40, Jackson, MS 39216. The listed phone number is (601) 200-4850.

What is Ear Nose And Throat Surgical Group's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Ear Nose And Throat Surgical Group was last updated on August 10, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.