Organization
R ANDREW PACKARD MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD ANDREW PACKARD MD (PRESIDENT)
(662) 624-2027
Entity
Organization
Contact information
Practice address
785 OHIO AVE STE 1F, CLARKSDALE, MS 38614-6213
(662) 627-2027
(662) 627-3424
Mailing address
785 OHIO AVE STE 1F, CLARKSDALE, MS 38614-6213
(662) 627-2027
(662) 627-3424
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
19744
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C04536
MEDICARE GROUP NUMBER
MS
Enumeration date
11/01/2006
Last updated
10/03/2007
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