# RIDGELAND FAMILY MEDICAL CTR

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285818005
- **Authorized official:** CAROLYN DURR (OFFICE MANAGER)
- **Authorized official phone:** (601) 856-9980

## Contact information

- **Practice address:** 305 HIGHWAY 51, RIDGELAND, MS 39157-3428
- **Practice address phone:** (601) 856-9980
- **Practice address fax:** (601) 856-9994
- **Mailing address:** 305 HIGHWAY 51, RIDGELAND, MS 39157-3428
- **Mailing address phone:** (601) 856-9980
- **Mailing address fax:** (601) 856-9994

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 10806 | MS | — |
| 207Q00000X | Family Medicine Physician | 12039 | MS | Yes |
| 261Q00000X | Clinic/Center | 12039 | MS | — |

## Other

- **Enumeration date:** 12/28/2007
- **Last updated:** 12/29/2011