Provider Demographics
NPI:1609960889
Name:FAUCETT, DONALD C (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:C
Last Name:FAUCETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1067 HIGHLAND COLONY PAKRWAY
Mailing Address - Street 2:SUITE G
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39157-8834
Mailing Address - Country:US
Mailing Address - Phone:601-707-3737
Mailing Address - Fax:601-853-2299
Practice Address - Street 1:1067 HIGHLAND COLONY PKWY
Practice Address - Street 2:SUITE G
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-8770
Practice Address - Country:US
Practice Address - Phone:601-707-3737
Practice Address - Fax:601-853-2299
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS10068207W00000X, 207N00000X, 207NS0135X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS180000050Medicare PIN
MSC83712Medicare UPIN