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General NPI Number Information
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NPI Number | 1306977848
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Entity Type | Organization
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Legal Business Name | MEDICAL FOUNDATION, INC.
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 1710 14TH ST
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City | MERIDIAN
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State | MS
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Zip | 39301-4140
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Country | US
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Telephone | 601-703-4415
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Fax | 601-703-4418
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Provider Business Mailing Address
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Address Line | DEPT 3020, PO BOX 1000
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City | MEMPHIS
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State | TN
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Zip | 38148-3020
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Country | US
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Telephone | 601-213-3010
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Fax | 601-213-3011
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Authorized Official
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Title or Position | REGIONAL CEO
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Name | DON LARKIN KENNEDY
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Credential |
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Telephone | 601-703-9614
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LX0106X
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Taxonomy Name | Occupational Health Nurse Practitioner
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License Number |
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License Number State |
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