Organization
E D MEDICAL CARE
Active
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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