Bacon, Janice

Bacon, Janice is an individual health care provider with primary practice located at 1668 W Peace St , Canton MS 39046-5332. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Bacon, Janice can be contacted via phone (601) 859-5213.

Contact Information

Primary practice address
1668 W Peace St Canton MS 39046-5332
Phone: (601) 859-5213
Fax: (601) 859-8771
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 10239 Mississippi

Profile Details

NPI number 1750438446
LBN Legal business name Bacon, Janice
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 4th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750438446 NPPES
Mississippi MEDICAID 00015416

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