NPI 1285894378

Wesley Dee Granger, M.D., P.A.

Organisation Preferred Provider Organization Ridgeland, MS

Practice location

Address: 12 Professional Pkwy, Ridgeland, MS 39157-4113
Phone: (601) 856-2460
Fax: (601) 856-4687

Authorised official

Name: Wesley Dee Granger
Title: Owner
Phone: (601) 856-2460

Registered specialties (2)

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 11037 (MS)

Other Preferred Provider Organization providers in Mississippi →

Point of Service

Managed Care Organizations Taxonomy 305S00000X Licence 11037 (MS)

Other Point of Service providers in Mississippi →

Registry record

NPI: 1285894378
Entity type: Organization
NPI issued: 11 Jun 2008
Record last updated: 11 Jun 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.