MEDICARE: MR. MACARTHUR INGE

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
1	172A00000X	Driver

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326223520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MACARTHUR INGE

Provider Business Mailing Address
First Line	:	3413 CAMELLIA CIRCLE
Second Line	:
City	:	COLUMBUS
State	:	MS
Zip	:	39705-1736
Country	:	US
Telephone Number	:	662-327-3643
Fax Number	:	663-328-9806

Provider Business Practice Location Address
First Line	:	3413 CAMELLIA CIRCLE
Second Line	:
City	:	COLUMBUS
State	:	MS
Zip	:	39705-1736
Country	:	US
Telephone Number	:	662-327-3643
Fax Number	:	663-328-9806

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/07/2008
Last Update Date	:	01/07/2008

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Directions to “ MR. MACARTHUR INGE ” Practice Location

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