Ennis, Calvin S
Ennis, Calvin S is an sole proprietor health care provider with primary practice located at 8006 Hwy 613 , Moss Point MS 39562. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Ennis, Calvin S can be contacted via phone (228) 475-1166.Contact Information
Primary practice address
8006 Hwy 613
Moss Point MS 39562
Phone: (228) 475-1166
Fax: (228) 475-9337
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 08202 | Mississippi |
Profile Details
| NPI number | 1144320920 |
|---|---|
| LBN Legal business name | Ennis, Calvin S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 22nd, 2006 |
| 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144320920 | NPPES |
| Mississippi | MEDICAID | 00115468 |
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