Provider Demographics
NPI:1316368343
Name:MCNAIR CHRONIC DISEASE CONSULTANT
Entity Type:Organization
Organization Name:MCNAIR CHRONIC DISEASE CONSULTANT
Other - Org Name:ROSIE L. WALKER-MCNAIR MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:WALKER-MCNAIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:601-982-1986
Mailing Address - Street 1:5120 GALAXIE DR STE B
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39206-4308
Mailing Address - Country:US
Mailing Address - Phone:601-982-1986
Mailing Address - Fax:601-982-8177
Practice Address - Street 1:5120 GALAXIE DR STE B
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39206-4308
Practice Address - Country:US
Practice Address - Phone:601-982-1986
Practice Address - Fax:601-982-8177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-17
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty