Provider Demographics
NPI:1942934203
Name:DPCTC, LLC
Entity Type:Organization
Organization Name:DPCTC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-707-3370
Mailing Address - Street 1:1107 HIGHLAND COLONY PKWY STE 219
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-6079
Mailing Address - Country:US
Mailing Address - Phone:601-707-3370
Mailing Address - Fax:601-707-3598
Practice Address - Street 1:1107 HIGHLAND COLONY PKWY STE 219
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-6079
Practice Address - Country:US
Practice Address - Phone:601-707-3370
Practice Address - Fax:601-707-3598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-13
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty