Organization
SOUTH RANKIN FAMILY CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RODERICK ANTHONY SHIELDS M.D. (OWNER)
(601) 664-2273
Entity
Organization
Contact information
Practice address
368 SCARBROUGH ST, SUITE B, RICHLAND, MS 39218-9038
(601) 664-2273
(601) 664-3472
Mailing address
368 SCARBROUGH ST, SUITE B, RICHLAND, MS 39218-9038
(601) 664-2273
(601) 664-3472
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12884
MS
Other
Enumeration date
11/21/2006
Last updated
08/22/2020
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