Mccormick, Eric Cleo

Mccormick, Eric Cleo is an sole proprietor health care provider with primary practice located at 15 West Eighth Avenue , Bay Springs MS 39422-0000. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Mccormick, Eric Cleo can be contacted via phone (601) 764-4173.

Contact Information

Primary practice address
15 West Eighth Avenue Bay Springs MS 39422-0000
Phone: (601) 764-4173
Fax: (601) 764-4975
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 2189-85 Mississippi

Profile Details

NPI number 1306860028
LBN Legal business name Mccormick, Eric Cleo
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 26th, 2006
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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306860028 NPPES
Other 764274 UNITED CONCORDIA PROV #
MEDICAID 00060212 UNITED CONCORDIA PROV #

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