Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2010-10-26
- Last updated
- 2010-10-26
Specialties
Licenses
- License MS
- 067
Location
- Practice location
- 242 THAGGARD RD
- City
- CARTHAGE MS
- Postal code
- 390519517
- Phone
- 601-267-6830
Organization contact
- Name
- REBECCA SHELTON
- Title
- Member
- Phone
- 6019568276
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
The OIG NPI list is not in this build yet. Confirm on OIG's search.
Nearby
Search this city from the state hub for other records in the public registry.
Removal request
Public data from NPPES and CMS. Not a credentialing determination.