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General NPI Number Information
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NPI Number | 1134102189
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Entity Type | Organization
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Legal Business Name | MICHAEL A TODD MD PA
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Dates
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Enumeration Date | 11/23/2005
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Last Update Date | 04/07/2009
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Provider Practice Location Address
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Address Line | 200 HWY 30 W
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City | NEW ALBANY
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State | MS
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Zip | 38652-3112
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Country | US
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Telephone | 662-538-2174
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Fax | 662-538-2139
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Provider Business Mailing Address
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Address Line | PO BOX 664
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City | NEW ALBANY
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State | MS
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Zip | 38652-0664
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Country | US
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Telephone | 662-538-2174
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Fax | 662-538-2139
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DR. MICHAEL A TODD
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Credential | M.D.
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Telephone | 662-538-2174
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 07937
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License Number State | MS
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