| Starkville Family Practice Pa | |
|
100 Brandon Rd Suite 5 Starkville MS 39759-2571 | |
| (662) 323-1212 | |
| Not Available |
| Full Name | Starkville Family Practice Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 100 Brandon Rd, Starkville, Mississippi |
| Authorized Official Name and Position | Michael Drew Anthony (PRESIDENT) |
| Authorized Official Contact | 6623231212 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Starkville Family Practice Pa 2478 Pike Rd Starkville MS 39759-7900 Ph: (662) 323-1212 | Starkville Family Practice Pa 100 Brandon Rd Suite 5 Starkville MS 39759-2571 Ph: (662) 323-1212 |
| NPI Number | 1215125711 |
|---|---|
| Provider Enumeration Date | 10/09/2007 |
| Last Update Date | 10/09/2007 |
| Medicare PECOS PAC ID | 2860576451 |
|---|---|
| Medicare Enrollment ID | O20080220000566 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215125711 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael Drew Anthony |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679641450 PECOS PAC ID: 2769566355 Enrollment ID: I20080220000609 |
| Provider Name | Foley Davis Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417430893 PECOS PAC ID: 9335485135 Enrollment ID: I20190116000841 |
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