MEDICARE: DR. DAN P WARLICK MD

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	208600000X	Surgery Physician	27507	IA

General Provider Information

NPI Number	:	1871565135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAN P WARLICK MD

Provider Business Mailing Address
First Line	:	830 S GLOSTER ST
Second Line	:
City	:	TUPELO
State	:	MS
Zip	:	38801-4934
Country	:	US
Telephone Number	:	662-317-2395
Fax Number	:	662-377-2397

Provider Business Practice Location Address
First Line	:	830 S GLOSTER ST
Second Line	:
City	:	TUPELO
State	:	MS
Zip	:	38801-4934
Country	:	US
Telephone Number	:	662-317-2395
Fax Number	:	662-377-2397

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

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	04/11/2017

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