| Wesley Physician Services Llc | |
|
5001 Hardy St Hattiesburg MS 39402-1308 | |
| (601) 268-8155 | |
| (601) 261-0508 |
| Full Name | Wesley Physician Services Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 5001 Hardy St, Hattiesburg, Mississippi |
| Authorized Official Name and Position | Jennifer L Jackson (SENIOR DIRECTOR PROVIDER ENROLLMENT) |
| Authorized Official Contact | 6154657000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wesley Physician Services Llc Po Box 689022 Franklin TN 37068-9022 Ph: (615) 465-7361 | Wesley Physician Services Llc 5001 Hardy St Hattiesburg MS 39402-1308 Ph: (601) 268-8155 |
| NPI Number | 1538200209 |
|---|---|
| Provider Enumeration Date | 02/08/2007 |
| Last Update Date | 06/03/2022 |
| Certification Date | 06/03/2022 |
| Medicare PECOS PAC ID | 2466559851 |
|---|---|
| Medicare Enrollment ID | O20070518000496 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538200209 | NPI | - | NPPES |
| 06476518 | Medicaid | MS | |
| 01726273 | Medicaid | MS | |
| 02639565 | Medicaid | MS | |
| 02706278 | Medicaid | MS | |
| 08883556 | Medicaid | MS | |
| 02606764 | Medicaid | MS | |
| 06827312 | Medicaid | MS | |
| 07236720 | Medicaid | MS | |
| 09776308 | Medicaid | MS | |
| 05925779 | Medicaid | MS | |
| 03277572 | Medicaid | MS | |
| 04727870 | Medicaid | MS | |
| 01505019 | Medicaid | MS | |
| 08955318 | Medicaid | MS | |
| 01080271 | Medicaid | MS | |
| 07687071 | Medicaid | MS | |
| 09236762 | Medicaid | MS |
| Provider Name | Curtis S Childress |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1922069921 PECOS PAC ID: 7911891668 Enrollment ID: I20040212000223 |
| Provider Name | Patrick W Omara |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467509331 PECOS PAC ID: 5496640260 Enrollment ID: I20040219000686 |
| Provider Name | Lowry Stanford |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013972306 PECOS PAC ID: 3870480056 Enrollment ID: I20040302001002 |
| Provider Name | Mohammed I Awaad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720039043 PECOS PAC ID: 4688669187 Enrollment ID: I20040415000421 |
| Provider Name | Alice Myers |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760447056 PECOS PAC ID: 7618964172 Enrollment ID: I20040427000967 |
| Provider Name | Sivarama K Kotikalapudi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124069521 PECOS PAC ID: 7618944380 Enrollment ID: I20040913000667 |
| Provider Name | Fisher A Covin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1184665580 PECOS PAC ID: 2668462276 Enrollment ID: I20040917000629 |
| Provider Name | Gardner Fletcher |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1114982485 PECOS PAC ID: 0840252854 Enrollment ID: I20041102000458 |
| Provider Name | Jerry Hyer |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1770548950 PECOS PAC ID: 4082676903 Enrollment ID: I20041102000589 |
| Provider Name | Robert W Watson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669413233 PECOS PAC ID: 5294762373 Enrollment ID: I20050720000566 |
| Provider Name | William L Reno |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1861580557 PECOS PAC ID: 3971523051 Enrollment ID: I20051205000338 |
| Provider Name | Kathleen A Messenger |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1174574701 PECOS PAC ID: 4284637257 Enrollment ID: I20061002000675 |
| Provider Name | Kurt F Bruckmeier |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083610117 PECOS PAC ID: 1658371265 Enrollment ID: I20070105000488 |
| Provider Name | Jennifer G Trihoulis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699891705 PECOS PAC ID: 9335248426 Enrollment ID: I20070702000276 |
| Provider Name | Wesley G Girod |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992893911 PECOS PAC ID: 5395823033 Enrollment ID: I20080422000512 |
| Provider Name | George J Azar |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1376632307 PECOS PAC ID: 0840254819 Enrollment ID: I20080422000553 |
| Provider Name | Joe Allen Harris |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275576233 PECOS PAC ID: 0244319135 Enrollment ID: I20080503000001 |
| Provider Name | Michael G May |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356345979 PECOS PAC ID: 9032111695 Enrollment ID: I20081121000445 |
| Provider Name | Charles R Moore |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1801058821 PECOS PAC ID: 2769535574 Enrollment ID: I20090727000543 |
| Provider Name | Nabih Alsheikh |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1023073251 PECOS PAC ID: 1658411954 Enrollment ID: I20091217000363 |
| Provider Name | Andrew C Lin |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1528172244 PECOS PAC ID: 5294864732 Enrollment ID: I20100521000581 |
| Provider Name | John Clayton Nelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366470056 PECOS PAC ID: 9931206620 Enrollment ID: I20100719000704 |
| Provider Name | William Edward Walker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184668246 PECOS PAC ID: 3870511165 Enrollment ID: I20100722000964 |
| Provider Name | Carrie M Smith |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1306126313 PECOS PAC ID: 5294908083 Enrollment ID: I20111021000355 |
| Provider Name | Stuart L Phillips |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1275763823 PECOS PAC ID: 1456547975 Enrollment ID: I20120327000425 |
| Provider Name | April E Hunt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467716548 PECOS PAC ID: 9436309382 Enrollment ID: I20121030000462 |
| Provider Name | John Charles Clemmons |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104916766 PECOS PAC ID: 6709807563 Enrollment ID: I20121106000568 |
| Provider Name | Peter J Jensen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831194471 PECOS PAC ID: 1355326414 Enrollment ID: I20130530000083 |
| Provider Name | Andrea Riels- Braswell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205184447 PECOS PAC ID: 2860620523 Enrollment ID: I20140102001154 |
| Provider Name | Anthony A Holden |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1720086606 PECOS PAC ID: 4183605439 Enrollment ID: I20140515001345 |
| Provider Name | Gagandeep S Grewal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114214038 PECOS PAC ID: 4688892029 Enrollment ID: I20140827001778 |
| Provider Name | Robin Elizabeth Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689066151 PECOS PAC ID: 5294052908 Enrollment ID: I20150317002245 |
| Provider Name | Nathan L Compton |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1316110745 PECOS PAC ID: 9234377847 Enrollment ID: I20151030000014 |
| Provider Name | Kosana Lee |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1508113606 PECOS PAC ID: 7113237637 Enrollment ID: I20151112000454 |
| Provider Name | Stephen E Massey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740374255 PECOS PAC ID: 0648580183 Enrollment ID: I20151112001040 |
| Provider Name | Astrid Yesenia Compton |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164696951 PECOS PAC ID: 6002054780 Enrollment ID: I20160426000810 |
| Provider Name | Brittany L Hollimon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073964946 PECOS PAC ID: 4789978727 Enrollment ID: I20160813000029 |
| Provider Name | Kirk A Moses |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669729729 PECOS PAC ID: 0244464865 Enrollment ID: I20170817004132 |
| Provider Name | Amy Ramsak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669459186 PECOS PAC ID: 0749285419 Enrollment ID: I20180410002318 |
| Provider Name | Dwight Anthony Dishmon |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1316904048 PECOS PAC ID: 9931165941 Enrollment ID: I20180608000039 |
| Provider Name | Leigh Ann Cochran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134608243 PECOS PAC ID: 7719238658 Enrollment ID: I20180917000971 |
| Provider Name | Stephen Gardner Fletcher |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669851846 PECOS PAC ID: 8426364662 Enrollment ID: I20180919003828 |
| Provider Name | William Michael Bird |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316431166 PECOS PAC ID: 4082959432 Enrollment ID: I20181213001070 |
| Provider Name | Alicia Pace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871145714 PECOS PAC ID: 0446588461 Enrollment ID: I20190828002065 |
| Provider Name | Sam S Dabit |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851746044 PECOS PAC ID: 3870889587 Enrollment ID: I20190930002037 |
| Provider Name | William Ellison Smithhart |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1831536713 PECOS PAC ID: 0143469122 Enrollment ID: I20191112001670 |
| Provider Name | Gregory Groglio |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1699791772 PECOS PAC ID: 3375549397 Enrollment ID: I20210226001940 |
| Provider Name | Garrett Cole Bond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326620220 PECOS PAC ID: 3375947674 Enrollment ID: I20210809003192 |
| Provider Name | Danny Boyd Mccaughan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1730236605 PECOS PAC ID: 9638598329 Enrollment ID: I20210823001605 |
| Provider Name | Megan Dunbar |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1417328949 PECOS PAC ID: 7810290871 Enrollment ID: I20210907003414 |
| Provider Name | Shedrieka Maye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245987098 PECOS PAC ID: 2961899067 Enrollment ID: I20220419002918 |
| Provider Name | Mallory Stockstill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205443165 PECOS PAC ID: 4284011099 Enrollment ID: I20220517002381 |
| Provider Name | Abhishek Kumar Jaiswal |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1780093831 PECOS PAC ID: 2668853706 Enrollment ID: I20220720001689 |
| Provider Name | Patricia Campbell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255991253 PECOS PAC ID: 0648507806 Enrollment ID: I20220913000853 |
| Provider Name | Edwin Seelye |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902253651 PECOS PAC ID: 6406149657 Enrollment ID: I20221109001210 |
| Provider Name | Abhishek Sawant |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1295990570 PECOS PAC ID: 0941360341 Enrollment ID: I20230209002531 |
| Provider Name | Rami Heart |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1891020079 PECOS PAC ID: 3577722511 Enrollment ID: I20230905001700 |
| Provider Name | Joshua Allen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073132783 PECOS PAC ID: 2062824345 Enrollment ID: I20230906001875 |
| Provider Name | Hora Nemati Rezvani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295363729 PECOS PAC ID: 5294151189 Enrollment ID: I20230922001782 |
| Provider Name | Talyr Hall |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902394174 PECOS PAC ID: 6608125018 Enrollment ID: I20231206003798 |
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 |