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General NPI Number Information
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NPI Number | 1295224954
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Entity Type | Organization
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Legal Business Name | FLORA PHYSICIANS, PLLC
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Dates
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Enumeration Date | 05/08/2018
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Last Update Date | 05/08/2018
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Provider Practice Location Address
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Address Line | 4848 MAIN ST
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City | FLORA
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State | MS
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Zip | 39071-9515
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Country | US
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Telephone | 769-300-1775
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX D
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City | FLORA
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State | MS
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Zip | 39071-1004
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Country | US
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Telephone | 769-300-1775
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Fax | 769-300-1775
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Authorized Official
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Title or Position | MEMBER
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Name | DR. MICAH R WALKER
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Credential | MD
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Telephone | 662-402-1219
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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