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General NPI Number Information
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NPI Number | 1790963536
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Entity Type | Organization
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Legal Business Name | CARE PLUS FAMILY MEDICINE - HIGHLAND COLONY
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Dates
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Enumeration Date | 02/04/2008
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Last Update Date | 08/21/2008
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Provider Practice Location Address
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Address Line | 100 BUSINESS PARK DR SUITES A & B
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City | RIDGELAND
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State | MS
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Zip | 39157-6015
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Country | US
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Telephone | 601-991-3040
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Fax | 601-991-3399
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Provider Business Mailing Address
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Address Line | 100 BUSINESS PARK DR SUITES A & B
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City | RIDGELAND
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State | MS
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Zip | 39157-6015
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Country | US
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Telephone | 601-991-3040
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Fax | 601-991-3399
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Authorized Official
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Title or Position | REGIONAL DIRECTOR
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Name | BRAD SINCLAIR
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Credential |
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Telephone | 601-936-3102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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