Organization
PRODOX, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDRE CREESE (AUTHORIZED OFFICIAL)
(800) 526-6797
Entity
Organization
Contact information
Practice address
27190 HIGHWAY 28, HAZLEHURST, MS 39083-2224
(601) 574-7000
Mailing address
1 INDIANA SQ STE 2060, INDIANAPOLIS, IN 46204-2004
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
11/05/2019
Last updated
11/05/2019
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