Mississippi Pac Services Professional Association | |
960 Highway 4 E Holly Springs MS 38635-2145 | |
(865) 693-1000 | |
Not Available |
Full Name | Mississippi Pac Services Professional Association |
---|---|
Speciality | Psychiatry & Neurology |
Location | 960 Highway 4 E, Holly Springs, Mississippi |
Authorized Official Name and Position | Rohit Uppal (PRESIDENT) |
Authorized Official Contact | 8656931000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Mississippi Pac Services Professional Association 265 Brookview Centre Way Ste 400 Knoxville TN 37919-4052 Ph: (865) 693-1000 | Mississippi Pac Services Professional Association 960 Highway 4 E Holly Springs MS 38635-2145 Ph: (865) 693-1000 |
NPI Number | 1073042925 |
---|---|
Provider Enumeration Date | 06/05/2017 |
Last Update Date | 06/07/2017 |
Medicare PECOS PAC ID | 7012273055 |
---|---|
Medicare Enrollment ID | O20171108001549 |
Identifier | Type | State | Issuer |
---|---|---|---|
1073042925 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084B0040X | Psychiatry & Neurology - Behavioral Neurology & Neuropsychiatry | (* (Not Available)) | Primary |
208M00000X | Hospitalist | (* (Not Available)) | Secondary |
Provider Name | Lakieva T Trotter |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1174791784 PECOS PAC ID: 1557432663 Enrollment ID: I20140408001374 |
Provider Name | Stacey Joyce Hubbard |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1811379639 PECOS PAC ID: 7911214689 Enrollment ID: I20150911001889 |
Provider Name | David B Hughes |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144490467 PECOS PAC ID: 8628155348 Enrollment ID: I20151110003053 |