Individual
DR. JOHN R FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
1901 MISSION 66, VICKSBURG, MS 39180-3711
(601) 636-0097
Mailing address
1901 MISSION 66, VICKSBURG, MS 39180-3711
(601) 636-8244
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
07650
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00124996
—
MS
Enumeration date
07/24/2006
Last updated
09/19/2011
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