Individual
JOSEPH R DANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
822 MAIN ST, ELLISVILLE, MS 39437-2425
(601) 477-2014
(601) 477-9942
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 477-2014
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16860
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00122374
—
MS
01
—
1559334
AMERICAN ADMIN GROUP
MS
05
—
1682322
—
LA
Enumeration date
08/03/2006
Last updated
07/14/2020
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