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NPI 1457465304

NPI 1457465304 : FLOYD NORMAN FORD D.M.D. : COLUMBUS, MS

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General NPI Number Information
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    NPI Number           |    1457465304
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    Entity Type          |    Individual 
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    Provider Name        |    FLOYD NORMAN FORD D.M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/18/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    2900 BLUECUTT RD SUITE 4
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    City                 |    COLUMBUS
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    State                |    MS
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    Zip                  |    39705-1470
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    Country              |    US
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    Telephone            |    662-329-1555
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    Fax                  |    662-329-2771
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Provider Business Mailing Address
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    Address Line         |    1524 HICKORY LN 
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    City                 |    COLUMBUS
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    State                |    MS
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    Zip                  |    39705-1513
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    Country              |    US
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    Telephone            |    662-327-5533
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223E0200X
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    Taxonomy Name        |    Endodontics
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    License Number       |    2674
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    License Number State |    MS
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