Provider Demographics
NPI:1922114123
Name:NEW BEGINNINGS FAMILY MEDICAL PRACTICE
Entity Type:Organization
Organization Name:NEW BEGINNINGS FAMILY MEDICAL PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:J. NAOMI
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDOR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:228-702-3020
Mailing Address - Street 1:147 REYNOIR ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39530-4109
Mailing Address - Country:US
Mailing Address - Phone:228-702-3020
Mailing Address - Fax:228-702-3025
Practice Address - Street 1:147 REYNOIR ST
Practice Address - Street 2:SUITE 205
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39530-4109
Practice Address - Country:US
Practice Address - Phone:228-702-3020
Practice Address - Fax:228-702-3025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS08101394Medicaid
MS04700893Medicaid
MS04700893Medicaid