Healthcare Provider Details

I. General information

NPI: 1821208372
Provider Name (Legal Business Name): NATCHEZ PODIATRY & FOOT SURGERY PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 04/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228C JOHN R JUNKIN DR
NATCHEZ MS
39120-3822
US

IV. Provider business mailing address

228C JOHN R JUNKIN DR
NATCHEZ MS
39120-3822
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 G MYERS
Title or Position: OFFICER
Credential: DPM
Phone: 601-446-9850