Provider Demographics
NPI:1679740492
Name:D AND F INC
Entity type:Organization
Organization Name:D AND F INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DESMOND
Authorized Official - Middle Name:W
Authorized Official - Last Name:HODA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:228-255-5328
Mailing Address - Street 1:4308 PARK TEN DR
Mailing Address - Street 2:
Mailing Address - City:DIAMONDHEAD
Mailing Address - State:MS
Mailing Address - Zip Code:39525-3222
Mailing Address - Country:US
Mailing Address - Phone:228-255-5328
Mailing Address - Fax:228-255-0026
Practice Address - Street 1:4308 PARK TEN DR
Practice Address - Street 2:
Practice Address - City:DIAMONDHEAD
Practice Address - State:MS
Practice Address - Zip Code:39525-3222
Practice Address - Country:US
Practice Address - Phone:228-255-5328
Practice Address - Fax:228-255-0026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS887111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS02500841Medicaid