R ANDREW PACKARD MD PC (NPI# 1902984966) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902984966 |
| Entity Type | Organization |
| Organization Name | R ANDREW PACKARD MD PC |
| Practice Address |
785 Ohio Ave Ste 1f Clarksdale MS 38614-6213 |
| Practice Telephone | 6626272027 |
| Practice Fax Number | 6626273424 |
| Mailing Telephone | 6626272027 |
| Mailing Fax Number | 6626273424 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-10-03 |
| Authorized Official Name | MR. RICHARD ANDREW PACKARD (PRESIDENT) |
| Authorized Official Telephone | 6626242027 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
19744 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | MEDICARE GROUP NUMBER | C04536 | 01 |
| Street Address |
785 OHIO AVE STE 1F |
| City | CLARKSDALE |
| State | MS |
| Zip Code | 38614-6213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386265627 | Lillie Mae Lockett | Technician | 1025 Ritchie Ave, Clarksdale, MS 38614 | 2020-04-28 |
| 1063957751 | Autospa-healthy Youth Center | Nurse Practitioner | 1202 Desoto Ave, Suite A, Clarksdale, MS 38614 | 2017-01-04 |
| 1700226123 | Nikki Nikkia Cager | Internal Medicine | 785 Ohio Ave Ste 2d, Clarksdale, MS 38614 | 2013-06-29 |
| 1205186947 | Celestial Comfort Care Hospice | Hospice Care, Community Based | 110 Yazoo Ave. Suite 212, Clarksdale, MS 38614 | 2012-09-10 |
| 1063667129 | The Smile Center of Clarksdale | Clinic/Center | 526 Choctaw Street, Suites B & C, Clarksdale, MS 38614 | 2008-11-17 |
| 1801060033 | Clarksdale Municipal School District | Local Education Agency (LEA) | Gycelle Tynes Educational Center, Friars Point Road, Clarksdale, MS 38614 | 2008-04-18 |
| 1184806150 | Mary A Williams | Nurse Practitioner | 125 Highway 322, Clarksdale, MS 38614 | 2007-12-03 |
| 1114040367 | William F Wilson Jr. | Dentist | 850 Desoto Ave, Extended, Clarksdale, MS 38614 | 2007-04-10 |
| 1952434920 | Kathleen Tinnel | Nurse Practitioner | 2245 N State St, Clarksdale, MS 38614 | 2007-03-13 |
| 1497888457 | Carole L Mangrem | Pediatrics | 2245 N Starte St, Clarksdale, MS 38614 | 2007-03-13 |
| Find all providers in zip 38614 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508984436 | Clarksdale Hma | Internal Medicine | 785 Ohio Ave, Suite 2f, Clarksdale, MS 38614-9734 | 2007-03-27 |
| 1780773762 | Richard E Brownstein | Internal Medicine | 785 Ohio Ave, Suite 3e, Clarksdale, MS 38614-6217 | 2006-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902374085 | St. Dominic Medical Associates LLC | Internal Medicine | 970 Lakeland Dr Ste 43, Jackson, MS 39216-4634 | 2018-11-07 |
| 1558774174 | Stephen Robert Chow | Internal Medicine | 1314 19th Ave Dept Of, Meridian, MS 39301-4116 | 2014-06-11 |
| 1568653939 | M Aftab Anwar | Internal Medicine | 3704 Beinville Blvd, Ocean Springs, MS 39564 | 2007-08-09 |
| 1720202450 | Amory Hma Physician Mgmt LLC | Internal Medicine | 1127 Earl Frye Blvd Ste A, Amory, MS 38821-5516 | 2007-04-12 |
| 1568594893 | Mohammad Aftab Anwar | Internal Medicine | 3704 Bienville Blvd, Suite A3, Ocean Springs, MS 39564-5710 | 2007-03-12 |
| 1740353515 | Deborah S. Skelton | Internal Medicine | 971 Lakeland Dr Ste 1160, Jackson, MS 39216-4609 | 2006-11-17 |
| 1376659193 | Navin V Barot | Internal Medicine | 1340 Broad Ave Ste 300, Gulfport, MS 39501-2404 | 2006-08-22 |
| 1437265972 | Javed Mohiuddin | Internal Medicine | Gulf Coast Veterans Health Care System, 400 Veterans Avenue, Biloxi, MS 39531-2410 | 2006-08-21 |
| 1558374850 | William M Farmer | Internal Medicine | 100 Methodist Blvd, Hattiesburg, MS 39402-1295 | 2006-08-15 |
| 1548276520 | Joseph Bailey | Internal Medicine | 1127 Earl Frye Blvd # A, Amory, MS 38821-5516 | 2006-07-31 |
| Find all providers with the same taxonomy | ||||
| City | CLARKSDALE |
| Zip Code | 38614 |
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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.