Provider Demographics
NPI:1073717302
Name:MCCOMB NEUROLOGY, PA
Entity Type:Organization
Organization Name:MCCOMB NEUROLOGY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:FARINA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:601-246-2491
Mailing Address - Street 1:118 N BROADWAY
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:MCCOMB
Mailing Address - State:MS
Mailing Address - Zip Code:39648-3914
Mailing Address - Country:US
Mailing Address - Phone:601-249-2491
Mailing Address - Fax:601-249-2885
Practice Address - Street 1:118 N BROADWAY
Practice Address - Street 2:2ND FLOOR
Practice Address - City:MCCOMB
Practice Address - State:MS
Practice Address - Zip Code:39648-3914
Practice Address - Country:US
Practice Address - Phone:601-249-2491
Practice Address - Fax:601-249-2885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS116642084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty