Internal Medicine Clinic of Clarksdale
NPI 1457554479ActiveOrganization· Specialist· Clarksdale, MS
Specialist in Clarksdale, Mississippi, registered in NPPES in June 2007. The authorized official on file is Sandra Blount, Office Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1457554479 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 7, 2007 |
| Last updated in NPPES | Jan 14, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Specialist Primary | 174400000X | 16074 | MS |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MS) |
|---|
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