| Forrest County General Hospital | |
|
6051 U S Highway 49 Hattiesburg MS 39401-7200 | |
| (601) 288-7000 | |
| (601) 288-1875 |
| Full Name | Forrest County General Hospital |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 6051 U S Highway 49, Hattiesburg, Mississippi |
| Authorized Official Name and Position | William C Oliver (PRESIDENT) |
| Authorized Official Contact | 6012884201 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Forrest County General Hospital 6051 U S Highway 49 Hattiesburg MS 39401-7200 Ph: (601) 288-7000 | Forrest County General Hospital 6051 U S Highway 49 Hattiesburg MS 39401-7200 Ph: (601) 288-7000 |
| NPI Number | 1295837631 |
|---|---|
| Provider Enumeration Date | 09/05/2006 |
| Last Update Date | 04/25/2008 |
| Medicare PECOS PAC ID | 1052397767 |
|---|---|
| Medicare Enrollment ID | O20040624001351 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295837631 | NPI | - | NPPES |
| 00020007 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 11141 (Mississippi) | Primary |
| Provider Name | Gary A Roberson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629133400 PECOS PAC ID: 1456252618 Enrollment ID: I20040120000367 |
| Provider Name | Terry D Ford |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912922949 PECOS PAC ID: 2961398102 Enrollment ID: I20040225000436 |
| Provider Name | Jeanne Nizigiye |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598833253 PECOS PAC ID: 1658268768 Enrollment ID: I20040303000422 |
| Provider Name | Cynthia Rouse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245331859 PECOS PAC ID: 3577453406 Enrollment ID: I20040316000903 |
| Provider Name | Mark O Rester |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538140512 PECOS PAC ID: 8820989205 Enrollment ID: I20040324000179 |
| Provider Name | Patricia Calabrese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346284130 PECOS PAC ID: 8426045808 Enrollment ID: I20040428000198 |
| Provider Name | Nanci W Parish |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245348689 PECOS PAC ID: 2466434873 Enrollment ID: I20040601000886 |
| Provider Name | Walter Gipson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023121555 PECOS PAC ID: 0244212454 Enrollment ID: I20040602000877 |
| Provider Name | Anwantbir Chawla |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205827656 PECOS PAC ID: 1557347952 Enrollment ID: I20040626000156 |
| Provider Name | Jed D Zak |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1053447037 PECOS PAC ID: 8921087941 Enrollment ID: I20040714001094 |
| Provider Name | Parveen Kumar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366544603 PECOS PAC ID: 6002896032 Enrollment ID: I20040721001010 |
| Provider Name | Wassim E Mouannes |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1780799965 PECOS PAC ID: 9133199680 Enrollment ID: I20040730000531 |
| Provider Name | William W Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093759722 PECOS PAC ID: 5698746964 Enrollment ID: I20040802001327 |
| Provider Name | Zina D Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134158579 PECOS PAC ID: 5193798916 Enrollment ID: I20040818001063 |
| Provider Name | Lacy Mcclain |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1427163724 PECOS PAC ID: 0749255933 Enrollment ID: I20040831001120 |
| Provider Name | Robert J Robbins |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1780792945 PECOS PAC ID: 1456326487 Enrollment ID: I20040901000620 |
| Provider Name | Bryan N Batson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104840958 PECOS PAC ID: 1052388006 Enrollment ID: I20040910000637 |
| Provider Name | John B Kayoma |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326063900 PECOS PAC ID: 5294703294 Enrollment ID: I20040917000763 |
| Provider Name | Eric W Enger |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1265442594 PECOS PAC ID: 8729057351 Enrollment ID: I20040929001137 |
| Provider Name | Robert G Wilkins |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1598875304 PECOS PAC ID: 5496724031 Enrollment ID: I20040929001196 |
| Provider Name | Thad F Waites |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1588773774 PECOS PAC ID: 5294718045 Enrollment ID: I20040929001219 |
| Provider Name | Leigh P Drace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013064245 PECOS PAC ID: 3375512916 Enrollment ID: I20040929001220 |
| Provider Name | Randel L Smith |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1639288293 PECOS PAC ID: 5092784645 Enrollment ID: I20040929001233 |
| Provider Name | Thomas S Messer |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1639284888 PECOS PAC ID: 7618946260 Enrollment ID: I20040929001248 |
| Provider Name | Rambod A Rouhbakhsh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285680264 PECOS PAC ID: 7214906643 Enrollment ID: I20041001000134 |
| Provider Name | Stephanie L Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376504357 PECOS PAC ID: 8224090303 Enrollment ID: I20041101000642 |
| Provider Name | Thomas E King |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1043324809 PECOS PAC ID: 3779548771 Enrollment ID: I20041201000157 |
| Provider Name | Angela C Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023122900 PECOS PAC ID: 4385637222 Enrollment ID: I20050118000619 |
| Provider Name | William Kergosien |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1730109018 PECOS PAC ID: 9436101003 Enrollment ID: I20050211000680 |
| Provider Name | Arthur C Martin |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1821103185 PECOS PAC ID: 6709830185 Enrollment ID: I20050309000113 |
| Provider Name | Maxie Lerone Gordon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427018613 PECOS PAC ID: 2466406798 Enrollment ID: I20050309000456 |
| Provider Name | Wendell R Helveston |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1881607158 PECOS PAC ID: 0345288536 Enrollment ID: I20050419000655 |
| Provider Name | Joe Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851347215 PECOS PAC ID: 1557301595 Enrollment ID: I20050509000928 |
| Provider Name | Benjamin Talbot Rester |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1568545176 PECOS PAC ID: 1254372212 Enrollment ID: I20050519000664 |
| Provider Name | Karen H Bruce |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942267281 PECOS PAC ID: 9436193422 Enrollment ID: I20050615000637 |
| Provider Name | Joseph A Proli |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1538277843 PECOS PAC ID: 8527002013 Enrollment ID: I20050615000691 |
| Provider Name | Lawrence J Leader |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1508970211 PECOS PAC ID: 8022088954 Enrollment ID: I20050616000373 |
| Provider Name | Kevin Galloway |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073507547 PECOS PAC ID: 3173568912 Enrollment ID: I20050622001193 |
| Provider Name | Steven D Woodward |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1730168196 PECOS PAC ID: 0042256828 Enrollment ID: I20050701000276 |
| Provider Name | Jackie Stuckey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689696627 PECOS PAC ID: 0042248387 Enrollment ID: I20050728000852 |
| Provider Name | Andrew Queler |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1336257690 PECOS PAC ID: 7214828193 Enrollment ID: I20050824000874 |
| Provider Name | Joanna M Hardy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174636195 PECOS PAC ID: 6800783291 Enrollment ID: I20050922000917 |
| Provider Name | Ronda M Vanderheiden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487619151 PECOS PAC ID: 1254356462 Enrollment ID: I20051006000824 |
| Provider Name | Antonio Jaime Imperial |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1902867021 PECOS PAC ID: 3971529298 Enrollment ID: I20051017000482 |
| Provider Name | Derrick R Duffield |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1922166867 PECOS PAC ID: 6204856958 Enrollment ID: I20051128000298 |
| Provider Name | Kenneth S Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407964844 PECOS PAC ID: 9931121480 Enrollment ID: I20051227000317 |
| Provider Name | Patricia Ann Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821032236 PECOS PAC ID: 5991729816 Enrollment ID: I20060118000960 |
| Provider Name | Earl L Mahaffey |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1689692972 PECOS PAC ID: 5799790978 Enrollment ID: I20060208000758 |
| Provider Name | Jason T Lane |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1003827478 PECOS PAC ID: 5597772004 Enrollment ID: I20060308000447 |
| Provider Name | Richard T Lane |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1447261805 PECOS PAC ID: 9931116803 Enrollment ID: I20060317000183 |
| Provider Name | Kevin H Holmes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942297858 PECOS PAC ID: 0244248094 Enrollment ID: I20060411000265 |
| Provider Name | Michele B Mahaffey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194745315 PECOS PAC ID: 9032112933 Enrollment ID: I20060815000164 |
| Provider Name | George J Blair |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1902835234 PECOS PAC ID: 5799788147 Enrollment ID: I20060824000463 |
| Provider Name | Shirley C Page |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730295619 PECOS PAC ID: 7810992849 Enrollment ID: I20060926000587 |
| Provider Name | Jonathan W Shook |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881703445 PECOS PAC ID: 5698770584 Enrollment ID: I20060928000025 |
| Provider Name | Bridget Y Tah-clayton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700877537 PECOS PAC ID: 7315946449 Enrollment ID: I20061218000556 |
| Provider Name | Ujwal R Neravetla |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1992882138 PECOS PAC ID: 2163421256 Enrollment ID: I20061219000464 |
| Provider Name | Robin D Greene - Brownlee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215035985 PECOS PAC ID: 8628078425 Enrollment ID: I20061229000186 |
| Provider Name | Robert B Brahan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881608586 PECOS PAC ID: 7416957212 Enrollment ID: I20061229000217 |
| Provider Name | Edmond E Wood |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1356321004 PECOS PAC ID: 7517932882 Enrollment ID: I20070212000070 |
| Provider Name | Fakhri Dalati |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013967835 PECOS PAC ID: 3173590320 Enrollment ID: I20070322000387 |
| Provider Name | Richard E Clatterbuck |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1205887338 PECOS PAC ID: 9739287939 Enrollment ID: I20070612000640 |
| Provider Name | Vanessa D Cox |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245440288 PECOS PAC ID: 2466553284 Enrollment ID: I20070724000462 |
| Provider Name | Bassam K Mechleb |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1063625325 PECOS PAC ID: 7911090295 Enrollment ID: I20070831000283 |
| Provider Name | Philip B Mellen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730108358 PECOS PAC ID: 9638131857 Enrollment ID: I20070910000635 |
| Provider Name | Amy Chanda Miller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265533038 PECOS PAC ID: 4981791555 Enrollment ID: I20071029000491 |
| Provider Name | Berthold Beisel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174546345 PECOS PAC ID: 4082704291 Enrollment ID: I20071212000061 |
| Provider Name | Christopher S Lynn |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386759603 PECOS PAC ID: 2961584396 Enrollment ID: I20080124000361 |
| Provider Name | Thomas Eric Hale |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790797389 PECOS PAC ID: 3870576622 Enrollment ID: I20080128000561 |
| Provider Name | Robert F Heath |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114930468 PECOS PAC ID: 3072695139 Enrollment ID: I20080128000680 |
| Provider Name | Jose P Fernandez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1144230491 PECOS PAC ID: 1355423096 Enrollment ID: I20080202000012 |
| Provider Name | Katherine P Alexis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861416042 PECOS PAC ID: 4981786621 Enrollment ID: I20080202000013 |
| Provider Name | Charles R Griffith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205891975 PECOS PAC ID: 9436150513 Enrollment ID: I20080219000493 |
| Provider Name | Brandon J Craft |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245431493 PECOS PAC ID: 9234213125 Enrollment ID: I20080303000187 |
| Provider Name | Gabriella Szatmary |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1972786150 PECOS PAC ID: 4486731932 Enrollment ID: I20080408000355 |
| Provider Name | Thomas A Miller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083658702 PECOS PAC ID: 3072691278 Enrollment ID: I20080428000534 |
| Provider Name | James A Marlowe |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952344913 PECOS PAC ID: 0840379954 Enrollment ID: I20080430000733 |
| Provider Name | Craig H Paterson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629011556 PECOS PAC ID: 2062591936 Enrollment ID: I20080502000465 |
| Provider Name | Peter S Kamp |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962445031 PECOS PAC ID: 9335228220 Enrollment ID: I20080503000000 |
| Provider Name | Ashley H Holford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053354027 PECOS PAC ID: 9133208572 Enrollment ID: I20080509000330 |
| Provider Name | Keith O Jones |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1316131568 PECOS PAC ID: 3375615669 Enrollment ID: I20080701000523 |
| Provider Name | Craig Thieling |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1952409609 PECOS PAC ID: 0244258556 Enrollment ID: I20080804000338 |
| Provider Name | Leah C Bennett |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831345412 PECOS PAC ID: 8325116155 Enrollment ID: I20081007000577 |
| Provider Name | Santo M Borganelli |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1235139866 PECOS PAC ID: 7911088323 Enrollment ID: I20081008000688 |
| Provider Name | Sergio I Gutierrez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558379776 PECOS PAC ID: 3870658362 Enrollment ID: I20090217000468 |
| Provider Name | William H Peters |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1679638621 PECOS PAC ID: 9133285133 Enrollment ID: I20090226000502 |
| Provider Name | Catherine C Hulsey |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1164483814 PECOS PAC ID: 3678582731 Enrollment ID: I20090630000315 |
| Provider Name | Thomas J Kelly |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629026596 PECOS PAC ID: 2163416165 Enrollment ID: I20090803000344 |
| Provider Name | Jeffrey N Johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689698318 PECOS PAC ID: 3870647266 Enrollment ID: I20090819000824 |
| Provider Name | Jessica A Mckenzie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750517660 PECOS PAC ID: 9133274269 Enrollment ID: I20090826000108 |
| Provider Name | Venkatasubramanian Baskararajan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407052228 PECOS PAC ID: 5496800229 Enrollment ID: I20090831000674 |
| Provider Name | Matthew Flynn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760618292 PECOS PAC ID: 5698811982 Enrollment ID: I20090929000516 |
| Provider Name | Ahmad A Haidar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407837503 PECOS PAC ID: 1254426760 Enrollment ID: I20091026000141 |
| Provider Name | Michael C Farmer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326082835 PECOS PAC ID: 5092850206 Enrollment ID: I20100226000319 |
| Provider Name | Brian Hollimon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881920817 PECOS PAC ID: 0345385282 Enrollment ID: I20100303000979 |
| Provider Name | Theresa Dueitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881817450 PECOS PAC ID: 4082740055 Enrollment ID: I20100329000920 |
| Provider Name | Jeffrey Johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275647117 PECOS PAC ID: 1658320858 Enrollment ID: I20100506000407 |
| Provider Name | Richard J Galloway |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1376553222 PECOS PAC ID: 3577692995 Enrollment ID: I20100524000588 |
| Provider Name | Cherie Papizan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1427166859 PECOS PAC ID: 5395874721 Enrollment ID: I20100524000718 |
| Provider Name | Charles D Hernandez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942213103 PECOS PAC ID: 6406985670 Enrollment ID: I20100526000575 |
| Provider Name | Olivia D Moran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447365606 PECOS PAC ID: 4587793641 Enrollment ID: I20100527000620 |
| Provider Name | James B Kot |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1144334814 PECOS PAC ID: 1557491321 Enrollment ID: I20100605000148 |
| Provider Name | Edward Askew |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1619991809 PECOS PAC ID: 8123158425 Enrollment ID: I20100614000135 |
| Provider Name | Pennie L Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710217914 PECOS PAC ID: 9032249107 Enrollment ID: I20100616000460 |
| Provider Name | Yvette Susi Folse |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1811929292 PECOS PAC ID: 1850421702 Enrollment ID: I20100619000046 |
| Provider Name | Brian S Archer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902834690 PECOS PAC ID: 5799817268 Enrollment ID: I20100719000722 |
| Provider Name | Daniel G Stevens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215137096 PECOS PAC ID: 4789877283 Enrollment ID: I20101214001033 |
| Provider Name | Shelton Allison |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538377981 PECOS PAC ID: 7416144514 Enrollment ID: I20101214001149 |
| Provider Name | Brandi Rawls Lockley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457641276 PECOS PAC ID: 4688852122 Enrollment ID: I20110701000253 |
| Provider Name | Angel M Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275705436 PECOS PAC ID: 2163691551 Enrollment ID: I20110801000261 |
| Provider Name | Stephanie D Bynum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609041532 PECOS PAC ID: 3375712607 Enrollment ID: I20110803000193 |
| Provider Name | Charles A May |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629364070 PECOS PAC ID: 0941470389 Enrollment ID: I20110823000387 |
| Provider Name | Santrise Goree |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770760357 PECOS PAC ID: 1456524305 Enrollment ID: I20111109000540 |
| Provider Name | Geralynn Morrison |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1710984539 PECOS PAC ID: 9638146897 Enrollment ID: I20120201000610 |
| Provider Name | Valerie N Evans |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396980116 PECOS PAC ID: 7315104056 Enrollment ID: I20120207000710 |
| Provider Name | Siddeeqah D Bilal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225234164 PECOS PAC ID: 3173782943 Enrollment ID: I20120316000270 |
| Provider Name | Pedro A Munera-cordoba |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528171469 PECOS PAC ID: 9436319811 Enrollment ID: I20120321000688 |
| Provider Name | Wissam K Mechleb |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1487841847 PECOS PAC ID: 2961667712 Enrollment ID: I20120629000397 |
| Provider Name | Matthew S Brashier |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1760682090 PECOS PAC ID: 8022132794 Enrollment ID: I20120711000594 |
| Provider Name | Scott Carroll |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1740438399 PECOS PAC ID: 6406002278 Enrollment ID: I20120809000764 |
| Provider Name | Deepak Khemka |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396922977 PECOS PAC ID: 0345499927 Enrollment ID: I20120926000387 |
| Provider Name | Oladipo Kusemiju |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215164769 PECOS PAC ID: 4385899731 Enrollment ID: I20130309000018 |
| Provider Name | Ivonne D Fernandez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922347699 PECOS PAC ID: 5698910990 Enrollment ID: I20130314000024 |
| Provider Name | Azad A Kabir |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285845933 PECOS PAC ID: 9931233681 Enrollment ID: I20130419000386 |
| Provider Name | Ronald P. Tynes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033450333 PECOS PAC ID: 9032355896 Enrollment ID: I20130424000008 |
| Provider Name | Jawauna Stewart |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1598077034 PECOS PAC ID: 7618114315 Enrollment ID: I20130802000558 |
| Provider Name | Billy Pearson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780025809 PECOS PAC ID: 5799929113 Enrollment ID: I20130924000799 |
| Provider Name | Christina I Williams |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356774772 PECOS PAC ID: 2264668706 Enrollment ID: I20131112000268 |
| Provider Name | Heather L Conn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275880601 PECOS PAC ID: 9133358849 Enrollment ID: I20140129000628 |
| Provider Name | Manpreet Khemka |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457509903 PECOS PAC ID: 6709017072 Enrollment ID: I20140331000422 |
| Provider Name | Adam Douglas Meyers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083021240 PECOS PAC ID: 6507083078 Enrollment ID: I20140806001249 |
| Provider Name | Holly M Kinget |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336376953 PECOS PAC ID: 6901026889 Enrollment ID: I20140926001175 |
| Provider Name | Stephanie P Myers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497150056 PECOS PAC ID: 9830412196 Enrollment ID: I20141218000795 |
| Provider Name | Katherine White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407992233 PECOS PAC ID: 0648594747 Enrollment ID: I20150120002306 |
| Provider Name | Carmen C Trawick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982939070 PECOS PAC ID: 2961642897 Enrollment ID: I20150122000174 |
| Provider Name | Jennifer F Pattie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457754855 PECOS PAC ID: 2860716776 Enrollment ID: I20150126000859 |
| Provider Name | Cynthia Mouton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013202563 PECOS PAC ID: 2163655788 Enrollment ID: I20150306000062 |
| Provider Name | Grettel Rodriguez Garcia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063836005 PECOS PAC ID: 2466770672 Enrollment ID: I20150421000133 |
| Provider Name | Edward Pellerano Guzman |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1255600607 PECOS PAC ID: 2769700848 Enrollment ID: I20150422000317 |
| Provider Name | Katie Rush |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891183208 PECOS PAC ID: 6204156821 Enrollment ID: I20150528000034 |
| Provider Name | Gregory Toczyl |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1104002047 PECOS PAC ID: 9830245869 Enrollment ID: I20150812007463 |
| Provider Name | Christopher John Douglas |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1427251511 PECOS PAC ID: 0941350102 Enrollment ID: I20150825003833 |
| Provider Name | Roopsi Bassi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053609586 PECOS PAC ID: 1850601402 Enrollment ID: I20151110002823 |
| Provider Name | Lewis W Aldred |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1720428121 PECOS PAC ID: 3678890928 Enrollment ID: I20151117002407 |
| Provider Name | Umesh C Bhandari |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548572274 PECOS PAC ID: 4183944648 Enrollment ID: I20160324000187 |
| Provider Name | Billy J Thornton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346691714 PECOS PAC ID: 2769778331 Enrollment ID: I20160907002606 |
| Provider Name | Judd M Reynolds |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730355967 PECOS PAC ID: 5799073581 Enrollment ID: I20170425000149 |
| Provider Name | April Hopstein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063961415 PECOS PAC ID: 3072890748 Enrollment ID: I20170505001016 |
| Provider Name | Cody C Choate |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487064697 PECOS PAC ID: 4688961428 Enrollment ID: I20170731000601 |
| Provider Name | William A Martin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336559327 PECOS PAC ID: 8921397233 Enrollment ID: I20170731000971 |
| Provider Name | Kory W Blackwell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255751525 PECOS PAC ID: 3173813748 Enrollment ID: I20170731000990 |
| Provider Name | Rami Jabbour |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1679980072 PECOS PAC ID: 2163793001 Enrollment ID: I20170810001644 |
| Provider Name | Richard C Calderone |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215340286 PECOS PAC ID: 3870818537 Enrollment ID: I20170818001931 |
| Provider Name | Jonathan K Trahan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326584822 PECOS PAC ID: 1850668757 Enrollment ID: I20170822001326 |
| Provider Name | William S Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538693510 PECOS PAC ID: 6103199641 Enrollment ID: I20170906001248 |
| Provider Name | Kelly F Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326561598 PECOS PAC ID: 3779856190 Enrollment ID: I20170907000729 |
| Provider Name | Rasheeda C Hall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114280591 PECOS PAC ID: 0345483004 Enrollment ID: I20171005001983 |
| Provider Name | Michelle S V Napper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720439029 PECOS PAC ID: 6103114459 Enrollment ID: I20171020000700 |
| Provider Name | Christopher M Hinson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952780066 PECOS PAC ID: 8426364829 Enrollment ID: I20180124001699 |
| Provider Name | Charles D Richardson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942640388 PECOS PAC ID: 3274840822 Enrollment ID: I20180321000935 |
| Provider Name | Sheila D Bullock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366943334 PECOS PAC ID: 8729342381 Enrollment ID: I20180507001172 |
| Provider Name | Deven Nicole Fejka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316464266 PECOS PAC ID: 8921363631 Enrollment ID: I20180530002263 |
| Provider Name | Barbara M Karcher |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558756387 PECOS PAC ID: 7012223290 Enrollment ID: I20180605000076 |
| Provider Name | Hina Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316387731 PECOS PAC ID: 5193033017 Enrollment ID: I20180703002389 |
| Provider Name | Rachel Hannaford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639686371 PECOS PAC ID: 0547516494 Enrollment ID: I20180706000791 |
| Provider Name | Paula Province Warren |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1932336302 PECOS PAC ID: 2961647375 Enrollment ID: I20180716003276 |
| Provider Name | Daniel James Edwards |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982098026 PECOS PAC ID: 7113212572 Enrollment ID: I20180720002608 |
| Provider Name | Stephanie Kay Bounds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740766252 PECOS PAC ID: 1153671300 Enrollment ID: I20180910000255 |
| Provider Name | Crystal Dale Grantham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336633791 PECOS PAC ID: 8426308446 Enrollment ID: I20180912000778 |
| Provider Name | Mohammad Ik Anindo |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1003299876 PECOS PAC ID: 4981910692 Enrollment ID: I20181109001066 |
| Provider Name | Lillian K Barnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821578097 PECOS PAC ID: 4183978455 Enrollment ID: I20181127000250 |
| Provider Name | Sara Duncan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285108662 PECOS PAC ID: 4183965726 Enrollment ID: I20190409002891 |
| Provider Name | Kimberly J Carver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528532173 PECOS PAC ID: 6305188459 Enrollment ID: I20190422001107 |
| Provider Name | Nathaniel Nowacki |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1508201872 PECOS PAC ID: 2062746878 Enrollment ID: I20190627003486 |
| Provider Name | Kaitlen Sicard Schexnayder |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1518386788 PECOS PAC ID: 8921335860 Enrollment ID: I20190814003520 |
| Provider Name | Alison Creel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720528680 PECOS PAC ID: 2466738422 Enrollment ID: I20190919002486 |
| Provider Name | Jessica Watson Lott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013567445 PECOS PAC ID: 3870926066 Enrollment ID: I20191202000848 |
| Provider Name | Ethel M Cobbett |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861696221 PECOS PAC ID: 3678730801 Enrollment ID: I20191202002284 |
| Provider Name | Chelsea Cockrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447804463 PECOS PAC ID: 5496189508 Enrollment ID: I20200311001959 |
| Provider Name | Frank Joseph Hux |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1003030578 PECOS PAC ID: 0446397756 Enrollment ID: I20200331002333 |
| Provider Name | Adam Harless |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1851653315 PECOS PAC ID: 0941429963 Enrollment ID: I20200709002502 |
| Provider Name | Brock N Banks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083147045 PECOS PAC ID: 1850662982 Enrollment ID: I20200716000680 |
| Provider Name | Laviesta L Ferrell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346651783 PECOS PAC ID: 2163846247 Enrollment ID: I20200722001427 |
| Provider Name | Sam Shamsnia |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1568773901 PECOS PAC ID: 2668698804 Enrollment ID: I20200824001623 |
| Provider Name | Lauren Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992394985 PECOS PAC ID: 3678987245 Enrollment ID: I20210122002302 |
| Provider Name | Terry Moran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598269920 PECOS PAC ID: 5799031712 Enrollment ID: I20210507002037 |
| Provider Name | Sarah M Hudson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225562705 PECOS PAC ID: 8921379165 Enrollment ID: I20210512001172 |
| Provider Name | Melissa Jo Ferrill Floyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982248571 PECOS PAC ID: 1850725011 Enrollment ID: I20210517001005 |
| Provider Name | Katherine Elizabeth Schubert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891320164 PECOS PAC ID: 5395145270 Enrollment ID: I20210615000468 |
| Provider Name | Aimee D Sundeen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1811359938 PECOS PAC ID: 4880989870 Enrollment ID: I20210628000852 |
| Provider Name | Patrick Dauphin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1962866004 PECOS PAC ID: 0941596654 Enrollment ID: I20210720002316 |
| Provider Name | Jennifer Mcadory |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568041291 PECOS PAC ID: 3274936224 Enrollment ID: I20210728001406 |
| Provider Name | Monica R Magee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164092201 PECOS PAC ID: 4789088352 Enrollment ID: I20210803003936 |
| Provider Name | Mauricio Rendon Bernot |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1710371760 PECOS PAC ID: 4082913595 Enrollment ID: I20210818000305 |
| Provider Name | Jonathan A Copp |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1457738528 PECOS PAC ID: 5799082129 Enrollment ID: I20210818003015 |
| Provider Name | Joseph Radley |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1346655792 PECOS PAC ID: 2264659929 Enrollment ID: I20210824000709 |
| Provider Name | Gregory Szych |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1841268521 PECOS PAC ID: 4688655467 Enrollment ID: I20210826000090 |
| Provider Name | Lindsay Luke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912676313 PECOS PAC ID: 2264839794 Enrollment ID: I20210924002082 |
| Provider Name | Jose Sosa Popoteur |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1285981332 PECOS PAC ID: 1254635444 Enrollment ID: I20211004003374 |
| Provider Name | Musunkumuki Kadochi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1275911810 PECOS PAC ID: 3173838331 Enrollment ID: I20211118002609 |
| Provider Name | Raymond Long |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1396055299 PECOS PAC ID: 5193983138 Enrollment ID: I20220210001387 |
| Provider Name | Maya A Babu |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1811208788 PECOS PAC ID: 4688847825 Enrollment ID: I20220217001254 |
| Provider Name | Matthew Byrnes |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1063545317 PECOS PAC ID: 9739280603 Enrollment ID: I20220223002495 |
| Provider Name | Courtney Lynn Cruthirds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285263103 PECOS PAC ID: 8628462256 Enrollment ID: I20220225000036 |
| Provider Name | Paul V Birinyi |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1851603906 PECOS PAC ID: 8022310473 Enrollment ID: I20220226000100 |
| Provider Name | Cynthia K Undesser |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841337656 PECOS PAC ID: 4082906490 Enrollment ID: I20220303002359 |
| Provider Name | Sebastian Koga |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1710191184 PECOS PAC ID: 7012140437 Enrollment ID: I20220310000948 |
| Provider Name | Andrew Michael Wishy |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1619389939 PECOS PAC ID: 8527332337 Enrollment ID: I20220321000037 |
| Provider Name | Shemecia Forthner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457806465 PECOS PAC ID: 6709174469 Enrollment ID: I20220701002386 |
| Provider Name | Erin Broome Riley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255063996 PECOS PAC ID: 7416330717 Enrollment ID: I20220823000845 |
| Provider Name | Jacob Daniel Kay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073262911 PECOS PAC ID: 9335516434 Enrollment ID: I20221102001885 |
| Provider Name | Brian Kenneth Lempa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891228144 PECOS PAC ID: 3072886589 Enrollment ID: I20221123002494 |
| Provider Name | Russell Douglas Goode |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1518278126 PECOS PAC ID: 1052552833 Enrollment ID: I20221128002327 |
| Provider Name | Justin Michael Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952034456 PECOS PAC ID: 3678942240 Enrollment ID: I20221205000883 |
| Provider Name | Georges El Khoury Antoun |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1265621130 PECOS PAC ID: 3971735275 Enrollment ID: I20230309002802 |
| Provider Name | David Nathan |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1194731240 PECOS PAC ID: 1254374903 Enrollment ID: I20230327000483 |
| Provider Name | Ketankumar V Bodarya |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831496165 PECOS PAC ID: 9032409313 Enrollment ID: I20230426001615 |
| Provider Name | Jefferson L Rogers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851824015 PECOS PAC ID: 2961808779 Enrollment ID: I20230711000026 |
| Provider Name | William P Fortenberry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235521923 PECOS PAC ID: 9436573433 Enrollment ID: I20230807003191 |
| Provider Name | Logan H Ramsey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578022307 PECOS PAC ID: 2860728052 Enrollment ID: I20240117000384 |
| Provider Name | Daniel Gloekler |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1346652849 PECOS PAC ID: 8022236355 Enrollment ID: I20240307002263 |
| Provider Name | Alicia Marie Pressley-moss |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1407112089 PECOS PAC ID: 9638515869 Enrollment ID: I20240311002765 |
| Provider Name | Jazmine D Franklin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780279976 PECOS PAC ID: 6103265731 Enrollment ID: I20240416002144 |
| Provider Name | Elvira Cehajic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710233721 PECOS PAC ID: 8123274156 Enrollment ID: I20240506000037 |
| Provider Name | Shannon L Runnels |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447951363 PECOS PAC ID: 5496113938 Enrollment ID: I20240529000711 |
The Hope Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 206 S 28th Ave, Hattiesburg, MS 39401 Phone: 601-264-0890 Fax: 601-261-0471 | |
Adcock Behavioral Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 211 Donwood Pl, Hattiesburg, MS 39401 Phone: 601-433-7950 | |
Ann-opal Counseling & Consulting, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1507 Hardy St, Suite 104, Hattiesburg, MS 39401 Phone: 601-336-6847 Fax: 601-510-9403 | |
Magnolia Behavioral Psychology Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6668 Hwy 98, Suite A, Hattiesburg, MS 39402 Phone: 601-348-7792 | |
Merit Health Wesley Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 5001 Hardy St, Hattiesburg, MS 39402 Phone: 601-268-8000 Fax: 601-268-5008 | |
Will's Way, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 604 Adeline St, Suite B, Hattiesburg, MS 39401 Phone: 601-466-9190 Fax: 186-662-5055 | |
Anchored Hope Clinic Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 423 Weathersby Rd Ste 180, Hattiesburg, MS 39402 Phone: 601-376-9144 Fax: 601-429-9300 |