Healthcare Provider Details

I. General information

NPI: 1457562175
Provider Name (Legal Business Name): JANAY L HARPER DPM PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 06/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

156 RIVER OAKS DR STE B
CANTON MS
39046-5376
US

IV. Provider business mailing address

156 RIVER OAKS DR STE B
CANTON MS
39046-5376
US

V. Phone/Fax

Practice location:
  • Phone: 601-855-4820
  • Fax: 601-855-7991
Mailing address:
  • Phone: 601-855-4820
  • Fax: 601-855-7991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number80186
License Number StateMS

VIII. Authorized Official

Name: JANAY L HARPER
Title or Position: MANAGER
Credential: DPM
Phone: 601-855-4820