# HERITAGE MEDICAL GROUP

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

## Provider details

- **NPI number:** 1578215422
- **Authorized official:** DAVID M KINCAID (OWNER)
- **Authorized official phone:** (662) 816-4071

## Contact information

- **Practice address:** 300 HERITAGE DR, OXFORD, MS 38655-5463
- **Practice address phone:** (662) 816-4071
- **Mailing address:** PO BOX 1105, OXFORD, MS 38655-1105
- **Mailing address phone:** (662) 816-4071

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 01/21/2022
- **Last updated:** 01/21/2022