Most Relevant Information
Provider Data
| NPI Number: | 1003466210 |
| Provider Name: | KIRK L LANDRUM |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: | AT0177 |
Most Important Dates
| Enumeration Date: | 09/19/2019 |
| Last Updated: | 09/19/2019 |
Provider Practice Location
23 MASON ST
LAUREL
MS
394404437
Practice Location Phone/Fax
| Phone: | 6013990547 |
| Fax: | 6014257585 |
Provider Mailing Location
43 LANDRUM RD
OVETT
MS
394643735
Provider Mailing Phone/Fax
| Phone: | 6013195879 |
| Fax: |