| Dr Charles L Nause Pa | |
|
110 E Market St Greenwood MS 38930-4430 | |
| (662) 453-5460 | |
| (662) 453-5551 |
| Full Name | Dr Charles L Nause Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 110 E Market St, Greenwood, Mississippi |
| Authorized Official Name and Position | Charles L Nause (PRESIDENT) |
| Authorized Official Contact | 6624535460 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Charles L Nause Pa 110 E Market St Greenwood MS 38930-4430 Ph: (662) 453-5460 | Dr Charles L Nause Pa 110 E Market St Greenwood MS 38930-4430 Ph: (662) 453-5460 |
| NPI Number | 1235398009 |
|---|---|
| Provider Enumeration Date | 06/05/2008 |
| Last Update Date | 06/05/2008 |
| Medicare PECOS PAC ID | 4981774452 |
|---|---|
| Medicare Enrollment ID | O20080610000623 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235398009 | NPI | - | NPPES |
| 00016402 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 11262 (Mississippi) | Primary |
| Provider Name | Charles L Nause |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154316008 PECOS PAC ID: 7517054851 Enrollment ID: I20071102000077 |
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