Active NPI 1407109945 Individual Practitioner Female Practitioner

Lea Ann Byrd , APRN

Nurse Practitioner • Marks, MS

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Lea Byrd, APRN is a certified Nurse Practitioner practicing in Marks, MS. With approximately 14 years of clinical experience since completing medical education in 2012, Lea Byrd delivers high-quality medical care to the local community at 1024 MARTIN LUTHER KING DR.

Lea Byrd accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, injection, ceftriaxone sodium, per 250 mg, injection beneath the skin or into muscle for therapy, diagnosis, or prevention. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1024 Martin Luther King Dr

Marks, MS 386461832

Telephone 6623263500

Associated Practice Facility / Clinic

🏢 Quitman County Hospital, Llc Facility NPI 1174989784

Medicare Profile & Education

Medical School

Other

Graduation Year

2012

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Marks, MS

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

14 Yrs Matches City Avg

City Avg: 14.0 Yrs

State Avg: 11.5 Yrs

Regional Practice Density

2 Specialists

Practicing in Marks, MS (1098 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

51.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Byrd (14 Years) 14 Yrs

Marks Specialty Average (14.0 Years) 14.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	1,407	327	$80.00	$71.79
J0696 Injection, ceftriaxone sodium, per 250 mg	1,239	165	$15.00	$0.45
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	1,155	236	$35.00	$11.20
36415 Insertion of needle into vein for collection of blood sample	1,151	322	$20.00	$8.62
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	1,052	319	$25.00	$7.59
J1100 Injection, dexamethasone sodium phosphate, 1 mg	896	187	$5.00	$0.11
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	653	160	$30.00	$17.85
87804 Detection test by immunoassay with direct visual observation for influenza virus	404	133	$25.00	$16.16
81002 Urinalysis, manual test	291	135	$5.00	$3.39
J1885 Injection, ketorolac tromethamine, per 15 mg	231	49	$15.00	$0.64
82947 Blood glucose (sugar) level	211	83	$12.00	$3.82
83036 Hemoglobin A1C level	182	86	$25.00	$9.43
J1580 Injection, garamycin, gentamicin, up to 80 mg	161	46	$20.00	$2.51
87426 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus	132	98	$60.00	$34.36
71046 X-ray of chest, 2 views	115	91	$35.00	$20.37
87811 Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)	82	67	$60.00	$40.16
93000 Routine ekg using at least 12 leads including interpretation and report	77	66	$35.00	$11.08
G0008 Administration of influenza virus vaccine	60	58	$25.00	$24.50
90661 Influenza vaccine, trivalent derived from cell cultures	58	58	$35.00	$34.30
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	50	40	$120.00	$101.65
86318 Test for detection of infectious agent antibody, qualitative or semiquantitative	42	38	$60.00	$17.73
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	40	40	$119.00	$87.90
96361 Hydration infusion into a vein	38	19	$150.00	$9.45
93925 Ultrasound of leg arteries or artery grafts	33	31	$300.00	$174.09
96360 Infusion into a vein for hydration, 31-60 minutes	27	22	$150.00	$24.52
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	23	22	$30.00	$16.20
93880 Ultrasound of both sides of head and neck blood flow	22	22	$250.00	$131.81
J2550 Injection, promethazine hcl, up to 50 mg	21	11	$12.00	$3.34
87428 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza	18	17	$150.00	$68.88
76700 Ultrasound of abdomen	17	16	$200.00	$69.24
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	16	13	$9.75	$1.24
73502 X-ray of hip, 2-3 views	14	13	$68.00	$32.03
72100 X-ray of lower and sacral spine, 2-3 views	14	14	$60.00	$25.24

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	1,163	298	$80.00	$69.43
36415 Insertion of needle into vein for collection of blood sample	1,040	315	$20.00	$8.35
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	959	210	$35.00	$10.74
J0696 Injection, ceftriaxone sodium, per 250 mg	930	153	$15.00	$0.51
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	858	304	$25.00	$7.57
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	681	192	$29.99	$17.23
J1100 Injection, dexamethasone sodium phosphate, 1 mg	574	155	$5.00	$0.12
82947 Blood glucose (sugar) level	258	89	$12.00	$3.81
81002 Urinalysis, manual test	255	109	$5.00	$3.37
J1885 Injection, ketorolac tromethamine, per 15 mg	190	41	$15.00	$0.53
87426 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus	175	123	$60.00	$34.62
83036 Hemoglobin A1C level	173	85	$25.00	$9.43
87804 Detection test by immunoassay with direct visual observation for influenza virus	142	60	$25.00	$16.22
71046 X-ray of chest, 2 views	105	89	$35.00	$19.97
93000 Routine ekg using at least 12 leads including interpretation and report	78	70	$35.00	$10.70
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	74	54	$120.00	$97.83
G0008 Administration of influenza virus vaccine	66	66	$25.00	$24.50
96361 Hydration infusion into a vein	40	17	$150.00	$9.49
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	34	34	$100.00	$75.81
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	33	29	$30.00	$16.20
90674 Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free	32	32	$35.25	$33.49
93880 Ultrasound of both sides of head and neck blood flow	26	26	$250.00	$129.47
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	25	25	$120.00	$86.41
96360 Infusion into a vein for hydration, 31-60 minutes	22	17	$150.00	$24.04
93925 Ultrasound of leg arteries or artery grafts	18	18	$300.00	$172.28
73560 X-ray of knee, 1-2 views	17	13	$56.47	$22.67
86318 Test for detection of infectious agent antibody, qualitative or semiquantitative	17	16	$60.00	$17.73
73502 X-ray of hip, 2-3 views	15	12	$68.00	$31.11
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	14	14	$180.00	$129.43
73030 X-ray of shoulder, minimum of 2 views	12	11	$75.00	$21.80
78267 Nuclear medicine study of digestive tract	11	11	$60.00	$10.84
72100 X-ray of lower and sacral spine, 2-3 views	11	11	$60.00	$24.89

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	1,155	323	$80.00	$69.85
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	1,117	235	$30.00	$17.38
36415 Insertion of needle into vein for collection of blood sample	1,077	345	$20.00	$2.93
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	913	324	$25.00	$7.58
J0696 Injection, ceftriaxone sodium, per 250 mg	848	142	$15.00	$0.49
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	686	236	$35.00	$10.92
J1100 Injection, dexamethasone sodium phosphate, 1 mg	627	182	$5.00	$0.12
87426 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus	496	276	$60.00	$41.75
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	288	141	$50.00	$43.57
81002 Urinalysis, manual test	237	116	$5.00	$3.39
J1885 Injection, ketorolac tromethamine, per 15 mg	232	54	$15.00	$0.53
82947 Blood glucose (sugar) level	171	92	$12.00	$3.84
83036 Hemoglobin A1C level	167	92	$25.00	$9.52
87804 Detection test by immunoassay with direct visual observation for influenza virus	121	55	$25.00	$15.95
G0008 Administration of influenza virus vaccine	89	88	$25.00	$24.52
80061 Blood test, lipids (cholesterol and triglycerides)	84	84	$35.60	$13.33
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	66	66	$119.32	$83.07
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	62	48	$120.00	$98.79
87502 Detection test by nucleic acid for multiple types influenza virus	53	41	$225.00	$94.89
90674 Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free	51	51	$36.00	$31.63
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	45	45	$180.00	$131.16
71046 X-ray of chest, 2 views	35	33	$35.00	$19.53
99202 New patient office or other outpatient visit, typically 20 minutes	25	25	$80.00	$54.81
78267 Nuclear medicine study of digestive tract	24	22	$60.00	$10.95
93000 Routine ekg using at least 12 leads including interpretation and report	21	21	$35.00	$11.03
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	21	21	$100.00	$70.25
J2550 Injection, promethazine hcl, up to 50 mg	19	16	$12.00	$2.59
96360 Infusion into a vein for hydration, 31-60 minutes	18	13	$150.00	$25.37

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	1,396	317	$76.10	$70.74
36415 Insertion of needle into vein for collection of blood sample	791	281	$15.75	$2.99
J0696 Injection, ceftriaxone sodium, per 250 mg	667	98	$15.00	$0.53
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	603	226	$25.00	$7.75
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	510	157	$27.24	$17.27
J1100 Injection, dexamethasone sodium phosphate, 1 mg	467	125	$6.77	$0.15
87426 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus	407	238	$61.70	$45.23
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	392	166	$35.00	$10.89
J1885 Injection, ketorolac tromethamine, per 15 mg	320	51	$15.00	$0.49
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	201	96	$48.46	$43.15
80061 Blood test, lipids (cholesterol and triglycerides)	151	149	$45.50	$13.39
81002 Urinalysis, manual test	141	76	$5.00	$3.48
83036 Hemoglobin A1C level	125	88	$25.00	$9.64
G0008 Administration of influenza virus vaccine	71	71	$25.00	$15.27
90756 Vaccine for influenza for injection into muscle	71	71	$36.00	$28.37
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	63	63	$106.67	$88.15
82947 Blood glucose (sugar) level	48	36	$12.00	$3.93
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	44	44	$168.64	$132.63
93000 Routine ekg using at least 12 leads including interpretation and report	41	38	$35.00	$11.37
87502 Detection test by nucleic acid for multiple types influenza virus	40	38	$225.00	$95.80
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	30	27	$113.00	$101.53

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	1,525	262	$70.01	$56.14
36415 Insertion of needle into vein for collection of blood sample	711	243	$20.00	$2.98
J0696 Injection, ceftriaxone sodium, per 250 mg	690	95	$15.00	$0.58
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	592	223	$25.00	$7.71
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	312	143	$34.97	$11.11
J1100 Injection, dexamethasone sodium phosphate, 1 mg	268	83	$8.00	$0.12
87426 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus	217	158	$74.86	$45.23
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	197	101	$40.00	$34.87
J1885 Injection, ketorolac tromethamine, per 15 mg	145	45	$15.00	$0.58
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	134	134	$100.30	$84.47
80061 Blood test, lipids (cholesterol and triglycerides)	117	115	$60.00	$13.32
83036 Hemoglobin A1C level	112	66	$25.00	$9.65
81002 Urinalysis, manual test	103	63	$5.00	$3.46
82947 Blood glucose (sugar) level	63	32	$12.00	$3.88
G0008 Administration of influenza virus vaccine	59	57	$25.00	$15.34
J2010 Injection, lincomycin hcl, up to 300 mg	44	13	$40.00	$12.48
87502 Detection test by nucleic acid for multiple types influenza virus	41	35	$225.00	$94.68
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	37	31	$100.00	$85.78
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	36	35	$36.00	$19.55
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	33	33	$155.00	$129.76
93000 Routine ekg using at least 12 leads including interpretation and report	31	29	$35.00	$13.11
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	29	14	$20.00	$17.69
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	25	25	$100.00	$99.76
G0009 Administration of pneumococcal vaccine	25	25	$25.00	$15.31
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	20	20	$100.00	$61.00
J2550 Injection, promethazine hcl, up to 50 mg	15	11	$12.00	$2.13
86677 Analysis for antibody to helicobacter pylori (gastrointestinal bacteria)	12	11	$60.00	$16.68
80053 Blood test, comprehensive group of blood chemicals	12	11	$40.00	$10.54

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	1,276	243	$70.00	$56.07
J0696 Injection, ceftriaxone sodium, per 250 mg	1,069	142	$15.00	$0.57
36415 Insertion of needle into vein for collection of blood sample	733	243	$20.00	$2.94
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	628	225	$25.00	$8.46
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	438	143	$40.00	$33.61
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	393	167	$35.00	$12.51
J1100 Injection, dexamethasone sodium phosphate, 1 mg	257	83	$8.00	$0.13
81002 Urinalysis, manual test	127	74	$5.00	$3.41
83036 Hemoglobin A1C level	109	69	$25.00	$10.57
G0008 Administration of influenza virus vaccine	79	79	$25.00	$15.04
J1885 Injection, ketorolac tromethamine, per 15 mg	76	23	$15.00	$0.53
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	73	73	$36.00	$18.65
80061 Blood test, lipids (cholesterol and triglycerides)	61	60	$57.54	$14.58
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	61	61	$100.00	$81.97
82947 Blood glucose (sugar) level	59	37	$12.00	$4.28
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	54	54	$155.00	$125.40
87502 Detection test by nucleic acid for multiple types influenza virus	39	32	$225.00	$93.88
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	38	26	$20.00	$17.10
93000 Routine ekg using at least 12 leads including interpretation and report	36	32	$35.00	$12.47
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	29	14	$8.00	$1.82
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	20	17	$100.00	$82.93

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	550	138	$68.84	$56.70
J0696 Injection, ceftriaxone sodium, per 250 mg	412	71	$32.91	$0.58
36415 Insertion of needle into vein for collection of blood sample	215	122	$20.00	$2.94
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	161	82	$33.85	$15.61
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	113	113	$100.00	$82.90
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	112	90	$25.00	$9.40
G0008 Administration of influenza virus vaccine	59	58	$25.00	$18.40
90656 Vaccine for influenza for administration into muscle, 0.5 ml dosage	59	58	$36.00	$19.37
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	46	30	$40.00	$33.78
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	44	44	$155.00	$125.96
83036 Hemoglobin A1C level	37	30	$25.00	$11.75
81002 Urinalysis, manual test	36	28	$5.00	$3.41
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	32	24	$20.00	$16.53
93000 Routine ekg using at least 12 leads including interpretation and report	28	28	$35.00	$12.71
82947 Blood glucose (sugar) level	19	15	$12.00	$4.75
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	16	14	$100.00	$84.00
80061 Blood test, lipids (cholesterol and triglycerides)	14	14	$30.00	$16.20
80053 Blood test, comprehensive group of blood chemicals	14	14	$40.00	$12.78

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	754	195	$70.08	$55.58
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	685	198	$25.00	$10.40
81000 Manual urinalysis test with examination using microscope, non-automated	412	159	$5.00	$4.24
J0696 Injection, ceftriaxone sodium, per 250 mg	360	60	$15.00	$0.64
80053 Blood test, comprehensive group of blood chemicals	357	166	$40.00	$14.19
80061 Blood test, lipids (cholesterol and triglycerides)	116	102	$30.00	$12.01
36415 Insertion of needle into vein for collection of blood sample	113	79	$20.00	$2.94
83036 Hemoglobin A1C level	106	60	$25.00	$12.97
71020 X-ray of chest, 2 views, front and side	85	69	$35.00	$20.74
93000 Routine ekg using at least 12 leads including interpretation and report	67	61	$35.00	$12.68
G0008 Administration of influenza virus vaccine	44	42	$22.00	$21.56
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	38	38	$36.00	$18.65
80051 Blood test panel for electrolytes (sodium potassium, chloride, carbon dioxide)	25	17	$30.00	$9.48
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	23	16	$20.00	$15.18
82947 Blood glucose (sugar) level	21	16	$12.00	$5.11
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	11	11	$100.00	$82.39
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	11	11	$40.00	$31.21

Medical Specialties & State Licenses

Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License MS R823849

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

06678813 (MS)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners

Lonnie Moore , NP

Nurse Practitioner - Family

NPI 1962852988

Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active June 10, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location June 10, 2015

Registered at 1024 MARTIN LUTHER KING DR, MARKS, MS 386461832 (Tel: 6623263500)

📍

Updated Business Mailing Address June 10, 2015

Registered at PO BOX 289, MARKS, MS 386460289 (Tel: 6623263500)

👤

Provider Name / Credentials Updated June 10, 2015

Recorded as LEA BYRD, APRN

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) June 10, 2015

Nurse Practitioner (License #R823849 in MS)

🟢

Initial NPI Registration & Enumeration October 22, 2012

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1407109945

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: October 22, 2012

Last Update: June 10, 2015

Sole Proprietor: No

Update or Correct Profile

Mailing Address

Po Box 289

Marks, MS 386460289

Phone: 6623263500

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.