OrganizationActive
Wesley Dee Granger, M.D., P.A.
NPI 1285894378 · Preferred Provider Organization · Ridgeland, MS
Provider details
- NPI number
- 1285894378
- Entity type
- Organization
- Primary specialty
- Preferred Provider OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Wesley Granger, Owner(601) 856-2460
- License
- 11037 (MS)
Specialties & taxonomies
Managed Care Organizations
Managed Care Organizations
Practice location
12 Professional Pkwy
Ridgeland, MS 39157-4113
Phone: (601) 856-2460
Fax: (601) 856-4687
Approximate (ZIP-level) locationGet directions
Mailing address
12 Professional Pkwy
Ridgeland, MS 39157-4113
Other names (DBA / former)
- Other name
- Madison-Ridgeland Medical Clinic
Registry dates
- Enumerated
- 2008-06-11
- Last updated
- 2008-06-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.