Active NPI
Plastic Surgery of North Ms PA
- Plastic Surgery Physician
- Tupelo, MS
National Provider Identifier
1679531255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- Legal business name
- PLASTIC SURGERY OF NORTH MS PA
- Practice address
- 4248 Eason Blvd
Suite B
Tupelo, MS 38801 - Phone
- (662) 842-8949
- Fax
- (662) 842-8995
- NPI assigned
- May 3, 2006
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Douglas Alan Pritchard, MD
- Title
- Owner
- Phone
- (662) 842-8949
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | NU | Primary |
Addresses
Primary practice location
4248 Eason Blvd
Suite B
Tupelo, MS 38801
Mailing address
4248 Eason Blvd
Suite B
Tupelo, MS 38801
Phone (662) 842-8949
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00018072 | Medicaid | MS |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Plastic Surgery Physician
- Tupelo, MS
- NPI 1467626390
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1679531255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4248 EASON BLVD",
"address_2": "SUITE B",
"city": "TUPELO",
"state": "MS",
"postal_code": "38801",
"telephone_number": "662-842-8949",
"fax_number": "662-842-8995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4248 EASON BLVD",
"address_2": "SUITE B",
"city": "TUPELO",
"state": "MS",
"postal_code": "38801",
"telephone_number": "662-842-8949",
"fax_number": "662-842-8995"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PLASTIC SURGERY OF NORTH MS PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-03",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "PRITCHARD",
"authorized_official_first_name": "DOUGLAS",
"authorized_official_middle_name": "ALAN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "662-842-8949",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00018072",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tupelo, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.