Provider Demographics
NPI:1548446966
Name:WOUND HEALING GROUP, P.A.
Entity type:Organization
Organization Name:WOUND HEALING GROUP, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BUFORD
Authorized Official - Middle Name:L
Authorized Official - Last Name:LAMBERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:662-620-8123
Mailing Address - Street 1:5221B CLIFF GOOKIN BLVD
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-6781
Mailing Address - Country:US
Mailing Address - Phone:662-620-8123
Mailing Address - Fax:662-620-8131
Practice Address - Street 1:5221B CLIFF GOOKIN BLVD
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-6781
Practice Address - Country:US
Practice Address - Phone:662-620-8123
Practice Address - Fax:662-620-8131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-16
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty