Provider Demographics
NPI:1467796284
Name:HERFORD INTERNAL MEDICINE PLLC
Entity Type:Organization
Organization Name:HERFORD INTERNAL MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARON
Authorized Official - Middle Name:
Authorized Official - Last Name:HERFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:662-287-6913
Mailing Address - Street 1:401 ALCORN DR
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:CORINTH
Mailing Address - State:MS
Mailing Address - Zip Code:38834-9072
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:401 ALCORN DR
Practice Address - Street 2:SUITE 2C
Practice Address - City:CORINTH
Practice Address - State:MS
Practice Address - Zip Code:38834-9072
Practice Address - Country:US
Practice Address - Phone:662-287-6913
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-16
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty