Basic Information
| Provider Information | |||||||||
| NPI: | 1093024614 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FRENCH | ||||||||
| FirstName: | CALVIN | ||||||||
| MiddleName: | JUNIOR | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | CFNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 114 N LEHMBERG RD | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | MS | ||||||||
| PostalCode: | 397025554 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6623292955 | ||||||||
| FaxNumber: | 6623286007 | ||||||||
| Practice Location | |||||||||
| Address1: | 114 LEHMBERG RD | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | MS | ||||||||
| PostalCode: | 397025554 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6623292955 | ||||||||
| FaxNumber: | 6623286007 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/30/2010 | ||||||||
| LastUpdateDate: | 06/23/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 853319 | MS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 07637854 | 05 | MS | MEDICAID |