is a Internal Medicine in Grenada, Mississippi. practices all healthcare services and medical treatments related to Internal Medicine. The NPI Number for is 1023129608. The last update date is .
's current location address is 1117 Sunset Dr, Grenada, Mississippi. You can contact this provider via phone number 6622261168 and fax number 6622261116. The mailing address for is 1117 Sunset Dr, Grenada, Mississippi. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 1117 Sunset Dr, Grenada, Mississippi |
| Phone Number | 6622261168 |
| Fax Number | 6622261116 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1023129608 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 1117 Sunset Dr |
|---|---|
| City | Grenada |
| State | Mississippi (MS) |
| Post Code | 389014080 |
| Phone Number | 6622261168 |
| Fax Number | 6622261116 |
Provider's Primary Taxonomy Detail
| Speciality | Internal Medicine |
|---|---|
| Taxonomy | 207R00000X |
| Licence No | 14339 |
|
Definition: A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and di |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 3354737 | MS | -- |
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