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Organization

JOHN R FORD MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN ROBERT FORD M.D. (PRESIDENT)
(601) 636-0097
Entity
Organization

Contact information

Practice address
1901 MISSION 66, VICKSBURG, MS 39180-3711
(601) 636-0097
(601) 629-9969
Mailing address
1901 MISSION 66, VICKSBURG, MS 39180-3711
(601) 636-0097
(601) 629-9969

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
12/21/2006
Last updated
07/14/2011
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