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NPI Code Detail

MEDICARE: MCNAIR CHRONIC DISEASE CONSULTANT

MEDICARE: MCNAIR CHRONIC DISEASE CONSULTANT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1316368343
Entity Type Code : Organization
Provider Name (Legal Business Name) : MCNAIR CHRONIC DISEASE CONSULTANT
Provider Business Mailing Address
First Line : 5120 GALAXIE DR STE B
Second Line :
City : JACKSON
State : MS
Zip : 39206-4308
Country : US
Telephone Number : 601-982-1986
Fax Number : 601-982-8177
Provider Business Practice Location Address
First Line : 5120 GALAXIE DR STE B
Second Line :
City : JACKSON
State : MS
Zip : 39206-4308
Country : US
Telephone Number : 601-982-1986
Fax Number : 601-982-8177
Authorized Official
Title or Position : OWNER
Name : DR. ROSIE L WALKER-MCNAIR
Credential : M.D.
Telephone Number : 601-982-1986
Provider Enumeration Date : 12/17/2013
Last Update Date : 12/17/2013

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Directions to “MCNAIR CHRONIC DISEASE CONSULTANT ” Practice Location

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