| R Andrew Packard Md Pc | |
|
785 Ohio Ave Ste 1f Clarksdale MS 38614-6213 | |
| (662) 627-2027 | |
| (662) 627-3424 |
| Full Name | R Andrew Packard Md Pc |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 785 Ohio Ave Ste 1f, Clarksdale, Mississippi |
| Authorized Official Name and Position | Richard Andrew Packard (PRESIDENT) |
| Authorized Official Contact | 6626242027 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| R Andrew Packard Md Pc 785 Ohio Ave Ste 1f Clarksdale MS 38614-6213 Ph: (662) 627-2027 | R Andrew Packard Md Pc 785 Ohio Ave Ste 1f Clarksdale MS 38614-6213 Ph: (662) 627-2027 |
| NPI Number | 1902984966 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 10/03/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902984966 | NPI | - | NPPES |
| C04536 | Other | MS | MEDICARE GROUP NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 19744 (Mississippi) | Primary |
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