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Organization

RIDGELAND FAMILY MEDICAL CTR

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CAROLYN DURR (OFFICE MANAGER)
(601) 856-9980
Entity
Organization

Contact information

Practice address
305 HIGHWAY 51, RIDGELAND, MS 39157-3428
(601) 856-9980
(601) 856-9994
Mailing address
305 HIGHWAY 51, RIDGELAND, MS 39157-3428
(601) 856-9980
(601) 856-9994

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
10806
MS
207Q00000X
Family Medicine Physician
Primary
12039
MS
261Q00000X
Clinic/Center
12039
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CB6301
RAILROAD MEDICARE
MS
Enumeration date
12/28/2007
Last updated
12/29/2011
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