| Md Billing, Llc | |
|
1855 Lakeland Dr Suite P231 Jackson MS 39216-4913 | |
| (601) 951-9863 | |
| (601) 487-8897 |
| Full Name | Md Billing, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1855 Lakeland Dr, Jackson, Mississippi |
| Authorized Official Name and Position | Gary A. Roberson (OWNER) |
| Authorized Official Contact | 6019519863 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Md Billing, Llc 1855 Lakeland Dr Suite P231 Jackson MS 39216-4913 Ph: (601) 951-9863 | Md Billing, Llc 1855 Lakeland Dr Suite P231 Jackson MS 39216-4913 Ph: (601) 951-9863 |
| NPI Number | 1548474042 |
|---|---|
| Provider Enumeration Date | 05/10/2007 |
| Last Update Date | 09/06/2023 |
| Certification Date | 09/06/2023 |
| Medicare PECOS PAC ID | 0648210831 |
|---|---|
| Medicare Enrollment ID | O20050506000374 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548474042 | NPI | - | NPPES |
| C05127 | Other | MN | MEDICARE PTAN |
| 009530543 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 15474 (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 | Arvinder Kaul |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396792578 PECOS PAC ID: 4486680121 Enrollment ID: I20050713000845 |
| Provider Name | Richard W George |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194768242 PECOS PAC ID: 8325064967 Enrollment ID: I20051021000785 |
| Provider Name | Christopher John Watkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598773897 PECOS PAC ID: 7113925330 Enrollment ID: I20061127000189 |
| Provider Name | Ralph L Burroughs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760674949 PECOS PAC ID: 0143402420 Enrollment ID: I20110308000397 |
| Provider Name | Jackie C Dyess |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003972928 PECOS PAC ID: 9436323540 Enrollment ID: I20111129000150 |
| Provider Name | Wendy Lee Bales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154608222 PECOS PAC ID: 5799951786 Enrollment ID: I20111221000467 |
| Provider Name | Laura King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801179791 PECOS PAC ID: 8325215924 Enrollment ID: I20120123000635 |
| Provider Name | Toni L. Ladner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922374057 PECOS PAC ID: 6507027588 Enrollment ID: I20120418000785 |
| Provider Name | Kimberly Dawn Harrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265505853 PECOS PAC ID: 5294996146 Enrollment ID: I20120419000649 |
| Provider Name | Kenneth R Daughtrey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902814361 PECOS PAC ID: 1153552963 Enrollment ID: I20140320000254 |
| Provider Name | Jana Paige Cline |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083043681 PECOS PAC ID: 0941433155 Enrollment ID: I20140515000771 |
| Provider Name | Noralyn C Blalock-perkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568745966 PECOS PAC ID: 1052534294 Enrollment ID: I20140516000022 |
| Provider Name | Stephanie Dearman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538544044 PECOS PAC ID: 3476869470 Enrollment ID: I20150908000970 |
| Provider Name | Kimberly B Rooks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134546559 PECOS PAC ID: 8123328697 Enrollment ID: I20151205000231 |
| Provider Name | Mazhar Salim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013075449 PECOS PAC ID: 4789775842 Enrollment ID: I20160413001187 |
| Provider Name | Deidra Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033585286 PECOS PAC ID: 7618260647 Enrollment ID: I20160727002573 |
| Provider Name | Donald Allan Dearman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679084024 PECOS PAC ID: 9830457597 Enrollment ID: I20171229001789 |
| Provider Name | Shenika Washington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457828428 PECOS PAC ID: 5890035844 Enrollment ID: I20190329000215 |
| Provider Name | Latonya Jaton Mcgowan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467018390 PECOS PAC ID: 7719219419 Enrollment ID: I20191030001144 |
| Provider Name | Paula G Perteet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164089322 PECOS PAC ID: 3375973555 Enrollment ID: I20200501000944 |
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