Healthcare Provider Details

I. General information

NPI: 1346964137
Provider Name (Legal Business Name): NATCHEZ PODIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2022
Last Update Date: 09/27/2022
Certification Date: 09/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 JEFF DAVIS BLVD STE H
NATCHEZ MS
39120-5140
US

IV. Provider business mailing address

PO BOX 18195
NATCHEZ MS
39122-8195
US

V. Phone/Fax

Practice location:
  • Phone: 601-446-9850
  • Fax: 601-446-9833
Mailing address:
  • Phone: 601-446-9850
  • Fax: 601-446-9833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD A MYERS JR.
Title or Position: PODIATRIST
Credential: DPM
Phone: 601-446-9850