Johnathon Beaux Mccormick in Gulfport - Dentist
Johnathon Beaux Mccormick - NPI 1508995879
Johnathon Beaux Mccormick is a Dentist in Gulfport, Mississippi. Johnathon Beaux Mccormick practices all healthcare services and medical treatments related to Dentist. The NPI Number for Johnathon Beaux Mccormick is 1508995879. The last update date is 2010-02-25.
Johnathon Beaux Mccormick's current location address is 3506 Washington Ave Ste I, Gulfport, Mississippi. You can contact this provider via phone number 2288681942 and fax number 2288681944. The mailing address for Johnathon Beaux Mccormick is 3506 Washington Ave Ste I, Gulfport, Mississippi. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Johnathon Beaux Mccormick |
|---|---|
| Address | 3506 Washington Ave Ste I, Gulfport, Mississippi |
| Phone Number | 2288681942 |
| Fax Number | 2288681944 |
| Sole Proprietor | Y |
| Credentials | D.M.D. |
NPI Number Detail
| NPI Number | 1508995879 |
|---|---|
| Provider Enumeration Date | 2007-03-05 |
| Last Updated Date | 2010-02-25 |
Provider Mailing Address Detail
| Address | 3506 Washington Ave Ste I |
|---|---|
| City | Gulfport |
| State | Mississippi (MS) |
| Post Code | 395073102 |
| Phone Number | 2288681942 |
| Fax Number | 2288681944 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 3134-00 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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What is the unique 10-digit identification code issued to Johnathon Beaux Mccormick by the Centers for Medicare & Medicaid Services?
The Johnathon Beaux Mccormick has been assigned the NPI (National Provider Identifier) 1508995879 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you provide the complete physical address where Johnathon Beaux Mccormick is located?
The Johnathon Beaux Mccormick is situated at the following address: 3506 Washington Ave Ste I, Gulfport, MS, 395073102.
What is Johnathon Beaux Mccormick's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Johnathon Beaux Mccormick's specialized field of practice is Dentist, and the corresponding taxonomy code that categorizes this area of specialization is 122300000X.
On what date did the Johnathon Beaux Mccormick receive its 1508995879 assignment from the Centers for Medicare & Medicaid Services?
The Johnathon Beaux Mccormick was assigned its 1508995879 by the Centers for Medicare & Medicaid Services on 2007-03-05.
When was the information regarding Johnathon Beaux Mccormick most recently updated?
The details pertaining to the Johnathon Beaux Mccormick, including its address, specialty, and other relevant information, were last refreshed on 2010-02-25.