# JOHN R FORD MD PA

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

## Provider details

- **NPI number:** 1437213766
- **Authorized official:** JOHN ROBERT FORD M.D. (PRESIDENT)
- **Authorized official phone:** (601) 636-0097

## Contact information

- **Practice address:** 1901 MISSION 66, VICKSBURG, MS 39180-3711
- **Practice address phone:** (601) 636-0097
- **Practice address fax:** (601) 629-9969
- **Mailing address:** 1901 MISSION 66, VICKSBURG, MS 39180-3711
- **Mailing address phone:** (601) 636-0097
- **Mailing address fax:** (601) 629-9969

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 07650 | MS | Yes |

## Other

- **Enumeration date:** 12/21/2006
- **Last updated:** 07/14/2011