Healthcare Provider Details

I. General information

NPI: 1598806895
Provider Name (Legal Business Name): CHARLES DAVID FINCH JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 06/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1828 RAYMOND RD
JACKSON MS
39204-4126
US

IV. Provider business mailing address

1828 RAYMOND RD
JACKSON MS
39204-4126
US

V. Phone/Fax

Practice location:
  • Phone: 601-331-2453
  • Fax: 601-372-3898
Mailing address:
  • Phone: 601-331-2453
  • Fax: 601-372-3898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number10768
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number10768
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: