Healthcare Provider Details

I. General information

NPI: 1407286529
Provider Name (Legal Business Name): JAMES PRICE P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2013
Last Update Date: 12/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 HIGHWAY 98 BYP
COLUMBIA MS
39429-3702
US

IV. Provider business mailing address

PO BOX 8419
BILOXI MS
39535-8087
US

V. Phone/Fax

Practice location:
  • Phone: 601-444-5050
  • Fax: 601-444-5072
Mailing address:
  • Phone: 228-388-5714
  • Fax: 228-388-0017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT2999
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: