Drg Fayette Pllc
NPI #1891978953 in Fayette, Mississippi
Provider Information
- NPI Number
- 1891978953
- Entity Type
- Organization
- Organization Name
- Drg Fayette Pllc
- Primary Specialty
- Clinic/Center - End-Stage Renal Disease (ESRD) Treatment
- Enumeration Date
- Dec 12, 2007
- Last Updated
- Jan 15, 2008
Practice Location
- Address
- 225 COMMUNITY DRIVE
- Address 2
- OFF HWY 61
- City
- Fayette
- State
- Mississippi
- ZIP Code
- 39069
- Phone
- (601) 786-6676
Authorized Official
- Name
- TUNDE OLUTADE
- Title
- MEMBER
- Phone
- (601) 899-3340
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - End-Stage Renal Disease (ESRD) Treatment — End-Stage Renal Disease (ESRD) Treatment |
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