Internal Medicine Clinic of Canton, Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

INTERNAL MEDICINE CLINIC OF CANTON, INC

Practice address

1116 Forest Ave
Jackson, MS 39206-3216

Phone

(601) 750-8376

NPI assigned

Dec 21, 2016

Organization subpart

No

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

Authorized official

Name

Louis James Saddler, MD

Title

Owner

Phone

(601) 750-8376

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1482278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482278400000",
    "number": "1669917068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9178",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728119178",
            "telephone_number": "479-498-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1116 FOREST AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392063216",
            "telephone_number": "601-750-8376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE CLINIC OF CANTON, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-21",
        "last_updated": "2016-12-21",
        "status": "A",
        "authorized_official_last_name": "SADDLER",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-750-8376",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2016; 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.