Provider Demographics
NPI:1386432961
Name:MISSISSIPPI OTOLARYNGOLOGY HEAD AND NECK SURGERY
Entity type:Organization
Organization Name:MISSISSIPPI OTOLARYNGOLOGY HEAD AND NECK SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:PIPPIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-905-7033
Mailing Address - Street 1:345 E LIVINGSTON PL
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-3943
Mailing Address - Country:US
Mailing Address - Phone:504-905-7033
Mailing Address - Fax:
Practice Address - Street 1:694 BELLE TERRE BLVD
Practice Address - Street 2:
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-1620
Practice Address - Country:US
Practice Address - Phone:504-905-7033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty