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DR. JAMES WILFRED ERVIN M.D.

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1619903580

Individual Registrant:
DR. JAMES WILFRED ERVIN M.D.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
104 W RAILROAD AVE S  CRYSTAL SPRINGS, MS 39059-2111 US
Tel: 601-892-3063  Fax: 601-892-3570

Contact information for business:
104 W RAILROAD AVE S  CRYSTAL SPRINGS, MS 39059-2111 US
Tel: 601-892-3063  Fax: --

Registration Information:
NPI: 1619903580
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
MS11355

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
C02939MS02
06726832MS05
08000379008




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