| Wilco Healthcare Of North Mississippi, Pllc | |
|
1514 Co Rd 41 Tupelo MS 38801 | |
| (662) 842-6776 | |
| Not Available |
| Full Name | Wilco Healthcare Of North Mississippi, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1514 Co Rd 41, Tupelo, Mississippi |
| Authorized Official Name and Position | Douglas Porter Anderson (OWNER/MEDICAL PROVIDER) |
| Authorized Official Contact | 6622552163 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wilco Healthcare Of North Mississippi, Pllc 731 Shady Oaks Cir Oxford MS 38655-5450 Ph: (662) 255-2163 | Wilco Healthcare Of North Mississippi, Pllc 1514 Co Rd 41 Tupelo MS 38801 Ph: (662) 842-6776 |
| NPI Number | 1821556838 |
|---|---|
| Provider Enumeration Date | 03/08/2019 |
| Last Update Date | 10/24/2022 |
| Medicare PECOS PAC ID | 8325389927 |
|---|---|
| Medicare Enrollment ID | O20190924000713 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821556838 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Troy J Ostrander |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437383718 PECOS PAC ID: 3072653153 Enrollment ID: I20091222000074 |
| Provider Name | Samuel J Creekmore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578538591 PECOS PAC ID: 8325187958 Enrollment ID: I20101117000269 |
| Provider Name | Lauren B Franks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215578752 PECOS PAC ID: 9638592454 Enrollment ID: I20200713000015 |
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