Organization
MADISON REGIONAL PHYSICIAN GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD SINCLAIR (REGIONAL MANAGER)
(601) 936-3102
Entity
Organization
Contact information
Practice address
1421 E PEACE ST, SUITE A, CANTON, MS 39046-4938
(601) 855-5131
Mailing address
1421 E PEACE ST, SUITE A, CANTON, MS 39046-4938
(601) 855-5131
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
08/07/2007
Last updated
08/07/2007
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