Organization
MCAFEE SAFETY ANALYSIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT DANIEL BRIDGEWATER (OFFICE ADMINSTRATOR)
(601) 812-6252
Entity
Organization
Contact information
Practice address
875 NORTHPARK DR STE 200, RIDGELAND, MS 39157-5223
(601) 812-6252
Mailing address
875 NORTHPARK DR STE 200, RIDGELAND, MS 39157-5223
(601) 812-6252
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
05/27/2021
Last updated
05/27/2021
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