Provider Demographics
NPI:1518105246
Name:RAMSEY E WILSON, DMD PLLC
Entity Type:Organization
Organization Name:RAMSEY E WILSON, DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-765-4405
Mailing Address - Street 1:PO BOX 729
Mailing Address - Street 2:
Mailing Address - City:COLLINS
Mailing Address - State:MS
Mailing Address - Zip Code:39428-0729
Mailing Address - Country:US
Mailing Address - Phone:601-765-4405
Mailing Address - Fax:601-765-0536
Practice Address - Street 1:802 S FIR AVE
Practice Address - Street 2:
Practice Address - City:COLLINS
Practice Address - State:MS
Practice Address - Zip Code:39428-4143
Practice Address - Country:US
Practice Address - Phone:601-765-4405
Practice Address - Fax:601-765-0536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00060189Medicaid