Richard Edwin Waller in Marks - Family Medicine
Richard Edwin Waller - NPI 1821001041
Richard Edwin Waller is a Family Medicine in Marks, Mississippi. Richard Edwin Waller practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Richard Edwin Waller is 1821001041. The last update date is 2017-03-01.
Richard Edwin Waller's current location address is 1024 Martin Luther King Drive, Marks, Mississippi. You can contact this provider via phone number 6623263502 and fax number 6623262555. The mailing address for Richard Edwin Waller is 1024 Martin Luther King Drive, Marks, Mississippi. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Richard Edwin Waller |
|---|---|
| Address | 1024 Martin Luther King Drive, Marks, Mississippi |
| Phone Number | 6623263502 |
| Fax Number | 6623262555 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1821001041 |
|---|---|
| Provider Enumeration Date | 2006-08-15 |
| Last Updated Date | 2017-03-01 |
Provider Mailing Address Detail
| Address | 1024 Martin Luther King Drive |
|---|---|
| City | Marks |
| State | Mississippi (MS) |
| Post Code | 386460289 |
| Phone Number | 6623263502 |
| Fax Number | 6623262555 |
Provider's Primary Taxonomy Detail
| Speciality | Family Medicine |
|---|---|
| Taxonomy | 207Q00000X |
| Licence No | 7067 |
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Definition: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine i |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 115098 | MS | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Richard Edwin Waller by the Centers for Medicare & Medicaid Services?
The Richard Edwin Waller has been assigned the NPI (National Provider Identifier) 1821001041. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Richard Edwin Waller is physically located?
The Richard Edwin Waller is physically situated at the following address: 1024 Martin Luther King Drive, Marks, MS, 386460289.
What is the Richard Edwin Waller's area of specialization and corresponding taxonomy classification?
The Richard Edwin Waller's specialty field is Family Medicine, and it falls under the taxonomy code 207Q00000X, which categorizes healthcare providers based on their specialties.
On what date was the 1821001041 assigned to Richard Edwin Waller?
The Richard Edwin Waller was issued its 1821001041 on 2006-08-15, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the Richard Edwin Waller's details last updated?
The information pertaining to the Richard Edwin Waller, including its address, specialty, and other details, was most recently updated on 2017-03-01.