| Jefferson County Hospital | |
|
870 South Main Street Fayette MS 39069-0577 | |
| (601) 786-3401 | |
| (601) 786-3400 |
| Full Name | Jefferson County Hospital |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 870 South Main Street, Fayette, Mississippi |
| Authorized Official Name and Position | Jerry Kennedy (INTERM CEO) |
| Authorized Official Contact | 6015974979 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jefferson County Hospital P.o. Box 577 870 Main Street Fayette MS 39069-0577 Ph: (601) 786-3401 | Jefferson County Hospital 870 South Main Street Fayette MS 39069-0577 Ph: (601) 786-3401 |
| NPI Number | 1043204555 |
|---|---|
| Provider Enumeration Date | 09/12/2005 |
| Last Update Date | 03/22/2024 |
| Certification Date | 03/22/2024 |
| Medicare PECOS PAC ID | 5496657876 |
|---|---|
| Medicare Enrollment ID | O20040227000452 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043204555 | NPI | - | NPPES |
| C02109 | Other | MS | BLUE CROSS BLUE SHIELD |
| Provider Name | Marvell Spears |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548365901 PECOS PAC ID: 2466351457 Enrollment ID: I20040108000414 |
| Provider Name | Victor O Anazia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245232792 PECOS PAC ID: 3476447996 Enrollment ID: I20040216000222 |
| Provider Name | John B Kayoma |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326063900 PECOS PAC ID: 5294703294 Enrollment ID: I20040917000763 |
| Provider Name | William Truly |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780893602 PECOS PAC ID: 3072556133 Enrollment ID: I20050609000226 |
| Provider Name | Toikus Westbrook |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285738468 PECOS PAC ID: 1153348362 Enrollment ID: I20061009000262 |
| Provider Name | Heather H Hager |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740347483 PECOS PAC ID: 4789780735 Enrollment ID: I20070508000268 |
| Provider Name | Derek L Holt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447470299 PECOS PAC ID: 0749356400 Enrollment ID: I20080903000310 |
| Provider Name | Harry G Hunt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346268786 PECOS PAC ID: 8527124239 Enrollment ID: I20090819000630 |
| Provider Name | Cinda Jackson Perryman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841699758 PECOS PAC ID: 6709166275 Enrollment ID: I20161130000482 |
| Provider Name | Jessica Ann Smith |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1154514651 PECOS PAC ID: 6204244684 Enrollment ID: I20210423001504 |
Mellow Minds Behavioral Health Wellness & Counseling Center Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 225 Community Dr, Fayette, MS 39069 Phone: 601-809-0500 | |
Jefferson County Hospital Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 870 Main St, Fayette, MS 39069 Phone: 601-786-3401 Fax: 601-786-3400 | |
Medgar Evers Solutions Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 210 Gilchrist St., Fayette, MS 39069 Phone: 601-786-3955 |