| Annyce R. Campbell M.d., Pa. | |
|
4510 Hanging Moss Rd Jackson MS 39206-3962 | |
| (769) 257-5713 | |
| (769) 257-5715 |
| Full Name | Annyce R. Campbell M.d., Pa. |
|---|---|
| Speciality | Family Medicine |
| Location | 4510 Hanging Moss Rd, Jackson, Mississippi |
| Authorized Official Name and Position | Annyce Ramona Campbell (PHYSICIAN) |
| Authorized Official Contact | 7692575713 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Annyce R. Campbell M.d., Pa. 4510 Hanging Moss Rd Jackson MS 39206-3962 Ph: () - | Annyce R. Campbell M.d., Pa. 4510 Hanging Moss Rd Jackson MS 39206-3962 Ph: (769) 257-5713 |
| NPI Number | 1063812683 |
|---|---|
| Provider Enumeration Date | 09/02/2014 |
| Last Update Date | 09/02/2014 |
| Medicare PECOS PAC ID | 6204055601 |
|---|---|
| Medicare Enrollment ID | O20140917001605 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063812683 | NPI | - | NPPES |
| 00012698 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 08563 (Mississippi) | Primary |
| Provider Name | Annyce Campbell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306938592 PECOS PAC ID: 2668548801 Enrollment ID: I20080911000560 |
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