Mid-south Neurology-sleep Medical Clinic Pllc | |
5740 Getwell Rd Bldg 6 Southaven MS 38672-6346 | |
(662) 396-9447 | |
(662) 396-9449 |
Full Name | Mid-south Neurology-sleep Medical Clinic Pllc |
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Speciality | Psychiatry & Neurology |
Location | 5740 Getwell Rd Bldg 6, Southaven, Mississippi |
Authorized Official Name and Position | Donald Humfeld (OFFICE MANAGER) |
Authorized Official Contact | 6623969447 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Mid-south Neurology-sleep Medical Clinic Pllc 5740 Getwell Rd Bldg 6 Southaven MS 38672-6346 Ph: (662) 396-9447 | Mid-south Neurology-sleep Medical Clinic Pllc 5740 Getwell Rd Bldg 6 Southaven MS 38672-6346 Ph: (662) 396-9447 |
NPI Number | 1538436167 |
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Provider Enumeration Date | 11/28/2011 |
Last Update Date | 10/07/2014 |
Medicare PECOS PAC ID | 7517132095 |
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Medicare Enrollment ID | O20111212000609 |
Identifier | Type | State | Issuer |
---|---|---|---|
1538436167 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | 18354 (Mississippi) | Primary |
Provider Name | William Earl Owens |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1770501173 PECOS PAC ID: 7618945643 Enrollment ID: I20040917000982 |
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