Individual
DR. ERIC LANDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
3401 MAIN ST, MOSS POINT, MS 39563-5101
(228) 762-7451
Mailing address
PO BOX 6705, GULFPORT, MS 39506-6705
(228) 865-1330
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1116211
LA
363LF0000X
Family Nurse Practitioner
Primary
R860220
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1116211
—
LA
Enumeration date
05/10/2006
Last updated
06/17/2011
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