# PROGRESSIVE PHYSICIANS PRACTICE

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

## Provider details

- **NPI number:** 1982783619
- **Authorized official:** DR. REMILEKUN SUBEDAT ADESOJI MD (OWNER)
- **Authorized official phone:** (662) 536-2100

## Contact information

- **Practice address:** 8412 AIRWAYS BLVD, SOUTHAVEN, MS 38671-5140
- **Practice address phone:** (662) 536-2100
- **Practice address fax:** (662) 536-2211
- **Mailing address:** PO BOX 1078, SOUTHAVEN, MS 38671
- **Mailing address phone:** (662) 536-2100
- **Mailing address fax:** (662) 536-2211

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 16532 | MS | Yes |
| 208000000X | Pediatrics Physician | 16591 | MS | — |

## Other

- **Enumeration date:** 11/03/2006
- **Last updated:** 11/04/2010