Provider Demographics
NPI:1477695815
Name:C. DAVID FINCH, JR., M.D.
Entity Type:Organization
Organization Name:C. DAVID FINCH, JR., M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLENDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-331-2453
Mailing Address - Street 1:1828 RAYMOND RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39204-4126
Mailing Address - Country:US
Mailing Address - Phone:601-373-7898
Mailing Address - Fax:601-373-7899
Practice Address - Street 1:1828 RAYMOND RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39204-4126
Practice Address - Country:US
Practice Address - Phone:601-373-7898
Practice Address - Fax:601-373-7899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09015046Medicaid
MSC02855Medicare PIN