Dr Dereck Davis, | |
2600 N State St, Jackson, MS 39216-4301 | |
(601) 984-5220 | |
(601) 984-5279 |
Full Name | Dr Dereck Davis |
---|---|
Gender | Male |
Speciality | Pediatric Medicine |
Experience | 23 Years |
Location | 2600 N State St, Jackson, Mississippi |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1174567580 | NPI | - | NPPES |
02170804 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 2007-00180 (North Carolina) | Secondary |
208000000X | Pediatrics | 18418 (Mississippi) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
State Of Mississippi - University Of Mississippi Medical Center | 1850293036 | 782 |
Entity Name | State Of Mississippi - University Of Mississippi Medical Center |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1154317527 PECOS PAC ID: 1850293036 Enrollment ID: O20090414000575 |
Mailing Address | Practice Location Address |
---|---|
Dr Dereck Davis, 2600 N State St, Jackson, MS 39216-4301 Ph: (601) 984-5220 | Dr Dereck Davis, 2600 N State St, Jackson, MS 39216-4301 Ph: (601) 984-5220 |
Lauren K Tucker, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2500 N State St, Jackson, MS 39216 Phone: 601-984-5260 Fax: 601-984-2652 | |
Kavipriya Komeswaran, Pediatrics Medicare: Medicare Enrolled Practice Location: 2500 N State St, Jackson, MS 39216 Phone: 601-815-2005 Fax: 601-815-0434 | |
Emily S Weber, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2500 N State St, Jackson, MS 39216 Phone: 601-984-4520 Fax: 601-984-5982 | |
Mr. Marcelo Eduardo Rains, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2500 North State Street, Ummc Neonatology, Jackson, MS 39216 Phone: 601-984-1000 | |
Logan Sears Havard, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2500 N State St, Jackson, MS 39216 Phone: 601-984-1000 | |
Dr. Eva Mae Henderson, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 350 W Woodrow Wilson Ave, Jackson, MS 39213 Phone: 601-709-5150 Fax: 601-709-5151 | |
Sitesh Ranen Roy, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2500 N State St, Jackson, MS 39216 Phone: 601-984-5249 |