| Dr John M Speca, MD | |
|
785 Ohio Ave Ste 1h, Clarksdale, MS 38614-6213 | |
| (662) 621-2438 | |
| (662) 621-2469 |
| Full Name | Dr John M Speca |
|---|---|
| Gender | Male |
| Speciality | Orthopaedic Surgery |
| Location | 785 Ohio Ave Ste 1h, Clarksdale, Mississippi |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659330090 | NPI | - | NPPES |
| P01676197 | Other | MS | RAILROAD MEDICARE PTAN |
| 036070970 | Medicaid | IL | |
| 08870040 | Medicaid | MS |
| Entity Name | Delta Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790701134 PECOS PAC ID: 6608775531 Enrollment ID: O20040108000636 |
| Entity Name | State Of Mississippi-university Of Mississippi Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154317527 PECOS PAC ID: 1850293036 Enrollment ID: O20090414000575 |
| Entity Name | Delta Health System |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609464619 PECOS PAC ID: 5597171645 Enrollment ID: O20210315002779 |
| Entity Name | Northwest Miss Regional Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598458515 PECOS PAC ID: 3173969177 Enrollment ID: O20240610002576 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr John M Speca, MD 785 Ohio Ave Ste 1h, Clarksdale, MS 38614-6213 Ph: (662) 621-2438 | Dr John M Speca, MD 785 Ohio Ave Ste 1h, Clarksdale, MS 38614-6213 Ph: (662) 621-2438 |
Dr. William D Henceroth Ii, MD Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 785 Ohio Ave, Suite 1h, Clarksdale, MS 38614 Phone: 662-621-2438 Fax: 662-621-2469 |