Provider Demographics
NPI:1093742389
Name:NORTH MISSISSIPPI FOOT SPECIALISTS, PC
Entity Type:Organization
Organization Name:NORTH MISSISSIPPI FOOT SPECIALISTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:C
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:662-513-6600
Mailing Address - Street 1:PO BOX 1233
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-1233
Mailing Address - Country:US
Mailing Address - Phone:662-513-6600
Mailing Address - Fax:662-513-0960
Practice Address - Street 1:1735A UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-4109
Practice Address - Country:US
Practice Address - Phone:662-513-6600
Practice Address - Fax:662-513-0960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS4984180010OtherCIGNA
MS02333593Medicaid
MS4984180010OtherCIGNA
MSC02723Medicare PIN
MS02333593Medicaid