Individual
MRS. DAWN MICHELE WALDROP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CFO
Contact information
Practice address
4155 HIGHWAY 178 W, RED BANKS, MS 38661-9603
(662) 551-2377
(662) 551-2372
Mailing address
4155 HIGHWAY 178 W, P.O. BOX 254, RED BANKS, MS 38661-9603
(662) 551-2377
(662) 551-2372
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
RFO02225
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06902890
—
MS
05
—
4582370
—
TN
Enumeration date
11/13/2006
Last updated
11/02/2007
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