NPI 1942740188

Personalized Wellness

Organisation General Practice Physician Ridgeland, MS

Practice location

Address: 573 Highway 51 STE D, Ridgeland, MS 39157-2605
Phone: (601) 955-1804

Authorised official

Name: Donald R Bonner
Title: Owner
Phone: (601) 955-1804

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence 13234 (MS)

Other General Practice providers in Mississippi →

Registry record

NPI: 1942740188
Entity type: Organization
NPI issued: 7 Mar 2017
Record last updated: 7 Mar 2017

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.