Individual
MARY BARRACK BIDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
103 KEATING CIR, CANTON, MS 39046-4561
(985) 705-3754
(985) 705-3754
Mailing address
778 LIBERTY RD, FLOWOOD, MS 39232-9300
(769) 243-6141
(769) 243-6141
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
3545
TN
363AS0400X
Surgical Physician Assistant
Primary
3545
TN
Other
Enumeration date
01/24/2018
Last updated
03/06/2023
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