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:
Health care specialties
| Specialty | Code | License # | 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 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750438446 | NPPES |
| Mississippi | MEDICAID | 00015416 |
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