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Organization
MADISON REGIONAL PHYSICIANS GROUP
Active
Organization
MADISON REGIONAL PHYSICIANS GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD SINCLAIR (REGIONAL MANAGER)
(601) 936-3113
Entity
Organization
Contact information
Practice address
1421 E PEACE ST, CANTON, MS 39046-4938
(601) 859-1331
Mailing address
1421 E PEACE ST, CANTON, MS 39046-4938
(601) 859-1331
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
NULL
207L00000X
Anesthesiology Physician
—
—
207P00000X
Emergency Medicine Physician
—
NULL
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
NULL
207RC0000X
Cardiovascular Disease Physician
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
—
NULL
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
03/20/2007
Last updated
09/11/2025
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