Healthcare Provider Details

I. General information

NPI: 1316931066
Provider Name (Legal Business Name): RICHARD W PHARR MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2005
Last Update Date: 11/17/2023
Certification Date: 11/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1490 WEST GOVERNMENT STREET SUITE 8 RICHARD W PHARR M.D. PA
BRANDON MS
39042
US

IV. Provider business mailing address

1490 WEST GOVERNMENT STREET SUITE 8 RICHARD W PHARR M.D. PA
BRANDON MS
39042
US

V. Phone/Fax

Practice location:
  • Phone: 601-825-0287
  • Fax: 601-825-1091
Mailing address:
  • Phone: 601-825-0287
  • Fax: 601-825-1091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number07701
License Number StateMS

VIII. Authorized Official

Name: DR. RICHARD WARREN PHARR
Title or Position: PRESIDENT
Credential: M.D.
Phone: 601-825-0287