DR. CHARLES WALKER MCCRARY (NPI# 1588787931) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588787931 |
| Entity Type | Individual |
| Full Name | DR. CHARLES WALKER MCCRARY |
| Credential | DDS, MS |
| Practice Address |
730 Goodman Rd E Ste B Southaven MS 38671-9530 |
| Mailing Address |
4355 W Cherry Place Dr Memphis TN 38117-3520 |
| Practice Telephone | 6623490079 |
| Practice Fax Number | 6623490779 |
| Mailing Telephone | 9016858919 |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
DS 2023 | TN | Dental Providers |
| Street Address |
730 GOODMAN RD E STE B |
| City | SOUTHAVEN |
| State | MS |
| Zip Code | 38671-9530 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396230090 | Michael Eli Vracar II | Dentist | 730 Goodman Rd E, Southaven, MS 38671-9530 | 2018-06-25 |
| 1225295744 | John George Kakales | Dentist | 730 Goodman Rd E, Suite A, Southaven, MS 38671-9530 | 2008-05-21 |
| 1710144225 | Charles Edwin Harbison | Dentist | 730 Goodman Rd E, Suite A, Southaven, MS 38671-9530 | 2008-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285196196 | Emma Tinsley-bowles Long | Social Worker | 8786 Northcreek Blvd, Bldg 8 Apt 3, Southaven, MS 38671 | 2019-04-01 |
| 1851847586 | Tiffany Lashea Jones | Adult Companion | 8755 Millbranch Road, Southaven, MS 38671 | 2016-09-01 |
| 1538526140 | Desoto Pediatric Extended Care LLC | Skilled Nursing Facility | 750 Stateline Road East, Southhaven, MS 38671 | 2016-01-27 |
| 1073983052 | Tara Burt | Physical Therapist | 7900 Airways Blvd. Building A, Suite 2, Southaven, MS 38671 | 2015-10-02 |
| 1295160463 | Ideal Community Care,llc | In Home Supportive Care | 8869 Centre Str #3, Southaven, MS 38671 | 2013-09-06 |
| 1578995692 | Gregory Charles Eakins Jr. | Optometrist | 338 Goodman Rd West, Southaven, MS 38671 | 2013-07-31 |
| 1295173169 | Erica R. Martin | Social Worker | 975 Swinnea Rdg Ste 3, Southaven, MS 38671 | 2013-06-12 |
| 1386918431 | Freds Stores of Tennessee Inc | Pharmacy | 710 Church Road, Southaven, MS 38671 | 2012-03-06 |
| 1740565613 | Mary Jeanette Scruggs | Pharmacist | 1011 Goodman Rd, Southaven, MS 38671 | 2011-10-11 |
| 1184919268 | First Pharmacy Services 5 | Pharmacy | 5185a Getwell Rd, Southaven, MS 38671 | 2011-06-16 |
| Find all providers in zip 38671 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649336017 | Steven J Fuson | Dentist | 7734 Airways, Southaven, MS 38671 | 2006-12-29 |
| 1639235963 | Dormois & Fuson, P.l.l.c. | Dentist | 7734 Airways Blvd, Southaven, MS 38671-5306 | 2006-12-29 |
| 1194825299 | Clyde Armstrong Musgrave | Dentist | 3964 Goodman Rd E Ste 128, Southaven, MS 38672-6494 | 2006-09-25 |
| 1720341100 | Nathaniel D Denson | Dentist | 7734 Airways Blvd, Southaven, MS 38671-5306 | 2012-06-20 |
| 1134285455 | John C Page | Dentist | 7734 Airways Blvd, Southaven, MS 38671-5306 | 2006-12-29 |
| 1841356169 | John A Acosta | Dentist | 7734 Airways Blvd, Southaven, MS 38671-5306 | 2006-12-29 |
| 1578658373 | North Mississippi Dental Specialists, Pllc | Dentist | 3964 Goodman Rd E Ste 128, Southaven, MS 38672-6494 | 2006-10-04 |
| 1477665065 | Jason Kenneth Coleman | Dentist | 3964 Goodman Rd E, Suite 128, Southaven, MS 38672-8761 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164938650 | Pediatric Dentistry of Corinth | Dentist | 1500 N Harper Rd #5, Pediatric Dentistry of Corinth, Corinth, MS 38834 | 2017-12-19 |
| 1669837910 | Laurel Dental Properties | Dentist | 1925 Pine Belt Drive, Laurel, MS 39440 | 2015-12-30 |
| 1669850004 | Jcc, LLC | Dentist | 1150 Monteith Avenue, Suite 102, Hernando, MS 38632 | 2015-05-18 |
| 1871971101 | Katherine Curtis Windham | Dentist | 300 Hospital Dr Ste 3, Columbus, MS 39705-1921 | 2015-05-06 |
| 1740673797 | Emilee Peeples Milling | Dentist | 1855 Crane Ridge Dr Ste 2, Jackson, MS 39216-4944 | 2015-03-16 |
| 1114359866 | Cmhp Enterprises | Dentist | 1420 Wooded Drive, Grenada, MS 38901 | 2013-08-05 |
| 1710327960 | Maegen Calhoun Mccabe | Dentist | 11280 E Taylor Rd, Suite B, Gulfport, MS 39503-4038 | 2013-07-02 |
| 1215280672 | Reggie H. Broom, D.m.d., P.a. | Dentist | 1635 E Pass Rd, Gulfport, MS 39507-3527 | 2012-10-23 |
| 1316216716 | Middleton & Belknap Pediatric Dentistry Pllc | Dentist | 6643 U S Highway 98, Hattiesburg, MS 39402-8442 | 2011-12-14 |
| 1194004994 | Eric L. Hyde, Dds, Pllc | Dentist | 15236 Dedeaux Rd, Gulfport, MS 39503-3161 | 2011-08-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.