Organization
FOOT AND SURGERY CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VERSHEEN EDWARDS D.P.M (PRESIDENT)
(601) 372-3222
Entity
Organization
Contact information
Practice address
7402 S SIWELL RD, SUITE 110, BYRAM, MS 39272-9386
(601) 372-3222
Mailing address
7402 S SIWELL RD, SUITE 110, BYRAM, MS 39272-9386
(601) 372-3222
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
80112
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00111109
—
MS
Enumeration date
06/30/2016
Last updated
08/21/2017
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