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General NPI Number Information
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NPI Number | 1841761129
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Entity Type | Organization
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Legal Business Name | DCGM, INC
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Dates
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Enumeration Date | 12/11/2018
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Last Update Date | 06/08/2023
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Provider Practice Location Address
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Address Line | 1040 RIVER OAKS DR STE 302
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City | FLOWOOD
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State | MS
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Zip | 39232-9575
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Country | US
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Telephone | 601-613-4254
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 321396
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City | FLOWOOD
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State | MS
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Zip | 39232-1396
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Country | US
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Telephone | 601-613-4254
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Fax | 601-939-9924
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Authorized Official
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Title or Position | NP
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Name | LORI M YOUNG
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Credential | NP
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Telephone | 601-850-2170
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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