John C. Mutziger I, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

10066 Issued in MS

Practice address

14884 Hwy 15
Decatur, MS 39327

Phone

(601) 635-2258

Fax

(601) 635-2259

NPI assigned

Nov 22, 2005

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 20, 2016.

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476921600000",
    "number": "1528041639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2106",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393022106",
            "telephone_number": "601-703-4282",
            "fax_number": "601-703-9283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14884 HWY 15",
            "city": "DECATUR",
            "state": "MS",
            "postal_code": "39327",
            "telephone_number": "601-635-2258",
            "fax_number": "601-635-2259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTZIGER",
        "first_name": "JOHN",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2016-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "10066",
            "primary": true
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "MS",
            "license": "10066",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00011490",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristin Lynne McDonald, PHARM.D.
• Deborah Allean Miller, R.N.
• Mississippi State Department of Health
• Krystle Monk
• Morgan W Morris, PTA
• Carri J Myers, PMHNP-BC
• Newton County Schools
• Region Ten Commission on Mental Health
• Amber Lynn Scoggin, M.S., CCC-SLP
• Kalena Yolanda Smith, LPN

• All providers in Decatur, MS
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.