Phillip Matthew Ezell, FNP-BC, AGACNP-BC | |
908 S George Ave, Petal, MS 39465-2077 | |
(601) 544-7441 | |
Not Available |
Full Name | Phillip Matthew Ezell |
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Gender | Male |
Speciality | Family Medicine - Adult Medicine |
Location | 908 S George Ave, Petal, Mississippi |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1689453524 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RC0200X | Internal Medicine - Critical Care Medicine | 905839 (Mississippi) | Secondary |
207QA0505X | Family Medicine - Adult Medicine | 905839 (Mississippi) | Primary |
Entity Name | Medical Systems Management, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1740555267 PECOS PAC ID: 5092964643 Enrollment ID: O20131024001113 |
Mailing Address | Practice Location Address |
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Phillip Matthew Ezell, FNP-BC, AGACNP-BC 120 Broken Arrow Trl, Petal, MS 39465-8952 Ph: (601) 466-8121 | Phillip Matthew Ezell, FNP-BC, AGACNP-BC 908 S George Ave, Petal, MS 39465-2077 Ph: (601) 544-7441 |
Rodney N Lovitt, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 50 Parkway Ln, Petal, MS 39465 Phone: 601-544-7404 Fax: 601-584-6457 | |
Mr. William Phillip Fortenberry Jr., Family Medicine Medicare: Medicare Enrolled Practice Location: 50 Parkway Ln, Petal, MS 39465 Phone: 601-544-7404 | |
Patricia Lurline Campbell, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 1146 Evelyn Gandy Pkwy, Petal, MS 39465 Phone: 601-584-4309 | |
John Clayton Nelson, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1146 Evelyn Gandy Pkwy, Petal, MS 39465 Phone: 601-584-4309 | |
Ronald A Bullock, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 50 Parkway Ln, Petal, MS 39465 Phone: 601-705-2897 Fax: 601-584-6457 | |
Donald V Conerly, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 50 Parkway Ln, Petal, MS 39465 Phone: 601-705-2897 Fax: 601-584-6457 | |
Dr. Robert Michael Weaver, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1146 Evelyn Gandy Pkwy, Petal, MS 39465 Phone: 601-584-4309 Fax: 601-584-4890 |