Active NPI
John M Packard Jr., M.D.
- Specialist
- Guntersville, AL
National Provider Identifier
1851308662
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 6719
- Practice address
- 45 Medical Park Dr.
Suite B
Guntersville, AL 35976 - Phone
- (256) 571-8969
- Fax
- (256) 571-8980
- NPI assigned
- Aug 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 6719 | AL | Primary |
Addresses
Primary practice location
45 Medical Park Dr.
Suite B
Guntersville, AL 35976
Mailing address
45 Medical Park Dr.
Suite B
Guntersville, AL 35976
Phone (256) 571-8969
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6719 | AL | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302566400000",
"number": "1851308662",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45 MEDICAL PARK DR.",
"address_2": "SUITE B",
"city": "GUNTERSVILLE",
"state": "AL",
"postal_code": "35976",
"telephone_number": "256-571-8969",
"fax_number": "256-571-8980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 MEDICAL PARK DR.",
"address_2": "SUITE B",
"city": "GUNTERSVILLE",
"state": "AL",
"postal_code": "35976",
"telephone_number": "256-571-8969",
"fax_number": "256-571-8980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PACKARD",
"first_name": "JOHN",
"middle_name": "M",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-02",
"last_updated": "2011-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "AL",
"license": "6719",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Guntersville, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.