Healthcare Provider Details

I. General information

NPI: 1356271027
Provider Name (Legal Business Name): MATTHEW FINEBURG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

859 WINTER ST
LUCEDALE MS
39452-6603
US

IV. Provider business mailing address

802 LAKELAND DR APT 248
JACKSON MS
39216-4622
US

V. Phone/Fax

Practice location:
  • Phone: 601-947-3161
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: