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General NPI Number Information
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NPI Number | 1801064290
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Entity Type | Organization
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Legal Business Name | MAGEE FAMILY FOOTCARE PLLC
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Dates
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Enumeration Date | 02/19/2008
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Last Update Date | 02/19/2008
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Provider Practice Location Address
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Address Line | 1663 SIMPSON HWY 49 STE 1
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City | MAGEE
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State | MS
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Zip | 39111
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Country | US
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Telephone | 601-849-0444
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Fax | 601-849-0404
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Provider Business Mailing Address
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Address Line | 1663 SIMPSON HWY 49 STE 1
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City | MAGEE
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State | MS
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Zip | 39111
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Country | US
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Telephone | 601-849-0444
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Fax | 601-849-0404
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Authorized Official
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Title or Position | OWNER/DPM
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Name | DR. DENVER L. CARTER III
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Credential | DPM
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Telephone | 601-849-0444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 80174
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License Number State | MS
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