| Wilco Healthcare Of North Mississippi, Pllc | |
|
2273 S Eason Blvd Tupelo MS 38804-5900 | |
| (662) 842-2461 | |
| Not Available |
| Full Name | Wilco Healthcare Of North Mississippi, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 2273 S Eason Blvd, Tupelo, Mississippi |
| Authorized Official Name and Position | Douglas Porter Anderson (OWNER/MEDICAL PROVIDER) |
| Authorized Official Contact | 6622552163 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wilco Healthcare Of North Mississippi, Pllc 1289 Ranchland Rd Belden MS 38826-8857 Ph: (662) 255-2163 | Wilco Healthcare Of North Mississippi, Pllc 2273 S Eason Blvd Tupelo MS 38804-5900 Ph: (662) 842-2461 |
| NPI Number | 1821556838 |
|---|---|
| Provider Enumeration Date | 03/08/2019 |
| Last Update Date | 05/19/2026 |
| Medicare PECOS PAC ID | 8325389927 |
|---|---|
| Medicare Enrollment ID | O20190924000713 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821556838 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Troy J Ostrander |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437383718 PECOS PAC ID: 3072653153 Enrollment ID: I20091222000074 |
| Provider Name | Samuel J Creekmore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578538591 PECOS PAC ID: 8325187958 Enrollment ID: I20101117000269 |
| Provider Name | Amy Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780469569 PECOS PAC ID: 4789048588 Enrollment ID: I20230913000113 |
| Provider Name | Shontel K Pierce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083441018 PECOS PAC ID: 3577098110 Enrollment ID: I20241120000331 |
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