MEDICARE: LATRICE FOX DILLARD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	M10447	MS

General Provider Information

NPI Number	:	1477346310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATRICE FOX DILLARD

Provider Business Mailing Address
First Line	:	2430 JOHNNY WALKER RD
Second Line	:
City	:	POTTS CAMP
State	:	MS
Zip	:	38659-9310
Country	:	US
Telephone Number	:	662-688-5848
Fax Number	:	662-688-5848

Provider Business Practice Location Address
First Line	:	6920 OAK FOREST DR
Second Line	:
City	:	OLIVE BRANCH
State	:	MS
Zip	:	38654-1332
Country	:	US
Telephone Number	:	662-892-2660
Fax Number	:	662-200-5842

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2025
Last Update Date	:	05/23/2025

Similar Medicare Providers

1801887591 — DR. SARAH BENNETT LAU PH.D.
Practice Location Address:

6978 OAK FOREST DR
OLIVE BRANCH, MS
38654-1332

Practice Phone: 662-895-1707
Practice Fax: 662-893-0388

1568092872 — JUAN CARLOS ZULUAGA BEDOYA P.A., RN, SA-C,
Practice Location Address:

5836 STONECREST DR
OLIVE BRANCH, MS
38654-0226

Practice Phone: 901-626-4635
Practice Fax:

1548263627 — CHARLES G RYAN JR. M.D.
Practice Location Address:

6819 CRUMPLER BLVD STE 101
OLIVE BRANCH, MS
38654-1941

Practice Phone: 662-890-5559
Practice Fax: 662-893-8323

1831194778 — MRS. STACY L WARDEN PT
Practice Location Address:

THE SMITH CLINIC FOR PHYSICAL THERAPY , 7037 HACKS CROSS ROAD
OLIVE BRANCH, MS
38654

Practice Phone: 662-890-7660
Practice Fax: 662-890-7661

1871592659 — WILLIAM HARDEE MCCLATCHY MD
Practice Location Address:

7163 GOODMAN RD
OLIVE BRANCH, MS
38654-1904

Practice Phone: 662-893-7878
Practice Fax: 662-874-1391

1124015821 — DR. ROBERT M PICKERING M.D.
Practice Location Address:

9085 SANDIDGE CENTER CV
OLIVE BRANCH, MS
38654-3575

Practice Phone: 901-861-9610
Practice Fax: 901-861-9611

Directions to “ LATRICE FOX DILLARD ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.