Organization Active NPI

Starkville Internal Medicine Clinic

  • Internal Medicine Physician
  • Starkville, MS
National Provider Identifier
1619084613
Registry record updated Jan 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
STARKVILLE INTERNAL MEDICINE CLINIC
Practice address
107 Brandon Rd
Starkville, MS 39759-2521
Phone
(662) 324-1291
Fax
(662) 324-2196
NPI assigned
Aug 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Benjamin F. Sanford Jr., M.D.
Title
President
Phone
(662) 324-1291

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X

Addresses

Primary practice location

107 Brandon Rd
Starkville, MS 39759-2521

Mailing address

107 Brandon Rd
Starkville, MS 39759-2521
Phone (662) 324-1291

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421280000000",
    "number": "1619084613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 BRANDON RD",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397592521",
            "telephone_number": "662-324-1291",
            "fax_number": "662-324-2196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 BRANDON RD",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397592521",
            "telephone_number": "662-324-1291",
            "fax_number": "662-324-2196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STARKVILLE INTERNAL MEDICINE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2015-01-15",
        "status": "A",
        "authorized_official_last_name": "SANFORD",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "662-324-1291",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Starkville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.