| Och Family Practice Ackerman | |
|
356 E Cherry St Ackerman MS 39735-9794 | |
| (662) 285-3243 | |
| (662) 285-3613 |
| Full Name | Och Family Practice Ackerman |
|---|---|
| Speciality | Clinic/Center |
| Location | 356 E Cherry St, Ackerman, Mississippi |
| Authorized Official Name and Position | James H. Jackson (CEO) |
| Authorized Official Contact | 6626152500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Och Family Practice Ackerman Po Box 1327 Starkville MS 39760-1327 Ph: () - | Och Family Practice Ackerman 356 E Cherry St Ackerman MS 39735-9794 Ph: (662) 285-3243 |
| NPI Number | 1114189644 |
|---|---|
| Provider Enumeration Date | 06/26/2008 |
| Last Update Date | 10/03/2022 |
| Medicare PECOS PAC ID | 9436217940 |
|---|---|
| Medicare Enrollment ID | O20081027000603 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114189644 | NPI | - | NPPES |
| 09409725 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 11-269 (Mississippi) | Primary |
| Provider Name | Prentiss M Parsons |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821051756 PECOS PAC ID: 9931206141 Enrollment ID: I20070523000452 |
| Provider Name | Amanda D Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679183610 PECOS PAC ID: 2961819826 Enrollment ID: I20210322001611 |
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