Individual
DR. ERIC CLEO MCCORMICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
15 WEST EIGHTH AVENUE, BAY SPRINGS, MS 39422-0000
(601) 764-4173
(601) 764-4975
Mailing address
PO BOX 928, BAY SPRINGS, MS 39422-0928
(601) 764-4173
(601) 764-4975
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2189-85
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00060212
—
MS
01
—
764274
UNITED CONCORDIA PROV #
—
Enumeration date
07/26/2006
Last updated
07/08/2007
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