FOUNDATION INTERNAL MEDICINE P.C. NPI 1255531885

NPI Information

FOUNDATION INTERNAL MEDICINE, P.C. is a primary care clinic center in Southaven, MS. FOUNDATION INTERNAL MEDICINE, P.C. NPI is 1255531885. The provider is registered as an organization entity type.

The provider's business location address is:

401 SOUTHCREST CIR
SUITE 207
SOUTHAVEN, MS
ZIP 38671-726
Phone: (662) 349-9292
Fax: (662) 349-8603

The provider's authorized official is Kenneth Osita Edmunds .
The authorized official title is Medical Director/president and has the following contact phone number (662) 349-9292.

The enumeration date for this NPI number is 7/22/2007 and was last updated on 7/22/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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