Provider Demographics
NPI:1316931066
Name:RICHARD W PHARR MD PA
Entity type:Organization
Organization Name:RICHARD W PHARR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:PHARR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:601-825-0287
Mailing Address - Street 1:1490 WEST GOVERNMENT STREET SUITE 8
Mailing Address - Street 2:RICHARD W PHARR M.D. PA
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39042
Mailing Address - Country:US
Mailing Address - Phone:601-825-0287
Mailing Address - Fax:601-825-1091
Practice Address - Street 1:1490 WEST GOVERNMENT STREET SUITE 8
Practice Address - Street 2:RICHARD W PHARR M.D. PA
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39042
Practice Address - Country:US
Practice Address - Phone:601-825-0287
Practice Address - Fax:601-825-1091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-08
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207W00000X
MS07701261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09016145Medicaid
MSB64759Medicare UPIN
MS180000281Medicare ID - Type Unspecified