Doctor Name: | RALPH T CAIN |
NPI Number: | 1245462282 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | FNP |
License Number: | R825333 |
Business Practice Address: | 1300 Sunset Dr Ste Q Grenada, MS - 389014086 |
Business Phone Number: | 6622949101 |
Business Fax Number: | 6622949104 |
Mailing Address: | 1300 Sunset Dr, Ste Q GRENADA |
State: | MS |
Postal Code: | 389014086 |
Phone Number: | 6622949101 |
Fax Number: | 6622949104 |
NPI Enumeration Date: | 08/10/2009 |
NPI Last Update Date: | 03/08/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R825333 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |