Provider Demographics
NPI:1962147926
Name:THE MEDICAL ARTHRITIS AND WELLNESS CLINIC OF MISSISSIPPI INC
Entity type:Organization
Organization Name:THE MEDICAL ARTHRITIS AND WELLNESS CLINIC OF MISSISSIPPI INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BARR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:662-483-1488
Mailing Address - Street 1:1800 CHERYL ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSDALE
Mailing Address - State:MS
Mailing Address - Zip Code:38614-7219
Mailing Address - Country:US
Mailing Address - Phone:662-483-1488
Mailing Address - Fax:662-483-1470
Practice Address - Street 1:1800 CHERYL STREET
Practice Address - Street 2:
Practice Address - City:CLARKSDALE
Practice Address - State:MS
Practice Address - Zip Code:38614-7219
Practice Address - Country:US
Practice Address - Phone:662-483-1488
Practice Address - Fax:662-483-1470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-03
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS10848OtherOSTEOARTHRITIS