Fredric Clark Puckett in Ennis - Family Medicine
Fredric Clark Puckett - NPI 1154596765
Fredric Clark Puckett is a Family Medicine in Ennis, Texas. Fredric Clark Puckett practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Fredric Clark Puckett is 1154596765. The last update date is 2022-04-05.
Fredric Clark Puckett's current location address is 2203 W Lampasas St Ste 111, Ennis, Texas. You can contact this provider via phone number 9728756200 and fax number 9728756414. The mailing address for Fredric Clark Puckett is 2203 W Lampasas St Ste 111, Ennis, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Fredric Clark Puckett |
|---|---|
| Address | 2203 W Lampasas St Ste 111, Ennis, Texas |
| Phone Number | 9728756200 |
| Fax Number | 9728756414 |
| Sole Proprietor | Y |
| Credentials | D.O. |
NPI Number Detail
| NPI Number | 1154596765 |
|---|---|
| Provider Enumeration Date | 2008-04-24 |
| Last Updated Date | 2022-04-05 |
Provider Mailing Address Detail
| Address | 2203 W Lampasas St Ste 111 |
|---|---|
| City | Ennis |
| State | Texas (TX) |
| Post Code | 751195667 |
| Phone Number | 9728756200 |
| Fax Number | 9728756414 |
Provider's Primary Taxonomy Detail
| Speciality | Family Medicine |
|---|---|
| Taxonomy | 207Q00000X |
| Licence No | N1080 |
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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 |
|---|---|---|---|
| 208303201 | TX | -- | |
| 208303202 | TX | -- |
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What is the unique identification code assigned to Fredric Clark Puckett by the Centers for Medicare & Medicaid Services?
The Fredric Clark Puckett has been issued the NPI (National Provider Identifier) 1154596765. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Where is the Fredric Clark Puckett located?
The Fredric Clark Puckett is located at 2203 W Lampasas St Ste 111, Ennis, TX 751195667.
What is Fredric Clark Puckett's area of expertise and its corresponding taxonomy classification?
The Fredric Clark Puckett's field of specialization is Family Medicine, and it falls under the taxonomy code 207Q00000X, which categorizes healthcare providers based on their areas of practice.
On what date did the Centers for Medicare & Medicaid Services assign the 1154596765 to Fredric Clark Puckett?
The Centers for Medicare & Medicaid Services assigned the 1154596765 to Fredric Clark Puckett on 2008-04-24.
When was the information regarding Fredric Clark Puckett most recently updated?
The details pertaining to the Fredric Clark Puckett, including its address, specialty, and other relevant information, were last refreshed on 2022-04-05.
NPI Number: 1336142389
Address: Po Box 2004, East Syracuse, NY