Healthcare Provider Details

I. General information

NPI: 1942123112
Provider Name (Legal Business Name): CAMERON LEIGH COTTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

877 NORTHPARK DR # 400
RIDGELAND MS
39157-5220
US

IV. Provider business mailing address

5918 HIGHWAY 22
BOLTON MS
39041-9154
US

V. Phone/Fax

Practice location:
  • Phone: 601-612-4275
  • Fax:
Mailing address:
  • Phone: 601-906-2294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: