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Organization

E D MEDICAL CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SANDRA M JONES (OFFICE MANAGER)
(662) 429-8802
Entity
Organization

Contact information

Practice address
2007 OAK TREE CV, SUITE 101, HERNANDO, MS 38632-1198
(662) 429-8802
(662) 429-8698
Mailing address
2007 OAK TREE CV, SUITE 201, HERNANDO, MS 38632-1198
(662) 429-8802
(662) 429-8698

Taxonomy

Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
M14539
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0120120
MS
05
02403537
MS
01
1003829680
NPI
MS
01
DC5472
CORP.GROUP
MS
01
P00175855
RAILROAD MEDICARE
MS
Enumeration date
12/05/2006
Last updated
08/22/2020
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