Cal-Med LLC
Family Medicine in Vicksburg, MS. Organization (NPI-2).
NPI number1417410911
StatusActive
Last updated in NPPESSep 17, 2024
Details
- NPI
- 1417410911
- Entity type
- Organization (NPI-2)
- Legal business name
- Cal-Med LLC
- Organization subpart
- No
- Enumeration date
- Apr 11, 2019
- Certification date
- Sep 17, 2024
- Last updated
- Sep 17, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Practice location
1901 Mission 66Vicksburg, MS 39180-3711
Phone 601-636-0097
Mailing address
1901 Mission 66Vicksburg, MS 39180-3711
Phone 601-636-0097
Authorized official
William Fulcher
Mgr
6016360097
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