Dr. Wirt Fletcher Shrock Jr., M.D.
Family Medicine in Durant, MS. Individual provider (NPI-1).
NPI number1497843676
StatusActive
Last updated in NPPESFeb 15, 2010
Details
- NPI
- 1497843676
- Entity type
- Individual (NPI-1)
- Name
- Dr. Wirt Fletcher Shrock Jr.
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 11, 2006
- Last updated
- Feb 15, 2010
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - FAMILY PRACTICE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 10738 | MS | Yes |
Practice location
630 Northwest AveDurant, MS 39063-3337
Phone 662-653-3012 · Fax 662-653-6423
Mailing address
630 Northwest AveDurant, MS 39063-3337
Phone 662-653-3012 · Fax 662-653-6423
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