Donald C Faucett, M.D.
Individual provider Active NPI Ophthalmology Physician · Ridgeland, MS
NPI 1609960889 · NPPES record last updated Jul 25, 2017
Key facts
- NPI
- 1609960889
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Ophthalmology Physician 207W00000X
- License
- 10068 (MS)
- Practice address
- 1067 Highland Colony Pkwy
Suite G
Ridgeland, MS 39157-8770 - Phone
- (601) 707-3737
- Fax
- (601) 853-2299
- NPI assigned
- Oct 3, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 12
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070607000738 | MS | Practitioner - Ophthalmology |
4385602705 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10068 | MS | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ms State Department of Health | Current |
Accepting new patients | |
| Mississippi State Department of Health | Current | Accepting new patients | |
| Ms State Dept of Health | Current |
Accepting new patients | |
| West Mississippi Behavioral Service, LLC | Current |
Accepting new patients | |
| Medical Associates of Vicksburg PLLC | Current |
Accepting new patients | |
| Vicksburg Hma Physician Management LLC | Current | Accepting new patients | |
| Ching Jygh Chen | Past | Accepting new patients | |
| Gptrs II | Past |
Accepting new patients | |
| Trustcare Primary Care, LLC | Family Medicine | Past | Accepting new patients |
| University Ophthalmology Associates | Ophthalmology | Past | Accepting new patients |
| Bradford River Bend, LLC | Past | Accepting new patients | |
| Bradford River Bend, LLC | Past | Accepting new patients |
Locations
570 E Woodrow Wilson Ave
Jackson, MS 39216
Phone (601) 576-7345
2080 S Frontage Rd
Ste 100
Vicksburg, MS 39180
Phone (601) 262-1000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 10068 | MS | Yes |
| Dermatology Physician | 207N00000X | 10068 | MS | |
| Procedural Dermatology Physician | 207NS0135X | 10068 | MS | |
| Family Medicine Physician | 207Q00000X | 10068 | MS |
Addresses
Primary practice location
1067 Highland Colony Pkwy
Suite G
Ridgeland, MS 39157-8770
Mailing address
1067 Highland Colony Pakrway
Suite G
Jackson, MS 39157-8834
Phone (601) 707-3737
Other providers in Ridgeland, MS
- Jacqueline Fairley Taylor
- Candice Fairley
- Family Chiropractic Care, LLC
- Family Eyecare Center, LLC
- Christina Dunn Farmer
- Fawaz Abdrabbo MD
- Fearless Beauty Company
- Molli E Fee
- Jenna N Feeney
- Daija Monei Fells
All providers in Ridgeland, MS · Ophthalmology Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 25, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.