Provider Demographics
NPI:1649716523
Name:DR. TODD FINCHER P.A.
Entity type:Organization
Organization Name:DR. TODD FINCHER P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:FINCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-453-1708
Mailing Address - Street 1:PO BOX 1531
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:38935-1531
Mailing Address - Country:US
Mailing Address - Phone:662-453-1708
Mailing Address - Fax:662-453-1785
Practice Address - Street 1:113 E MARKET ST
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:MS
Practice Address - Zip Code:38930-4429
Practice Address - Country:US
Practice Address - Phone:662-453-1708
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-16
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BC3200X
MS227286122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty