| Baptist Medical Center-leake, Inc | |
|
1225 N State St Jackson MS 39202-2064 | |
| (601) 968-1000 | |
| Not Available |
| Full Name | Baptist Medical Center-leake, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1225 N State St, Jackson, Mississippi |
| Authorized Official Name and Position | Gregory M Duckett (SR VP/ CLO) |
| Authorized Official Contact | 9012275233 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Baptist Medical Center-leake, Inc 350 N Humphreys Blvd Memphis TN 38120-2177 Ph: (601) 968-1000 | Baptist Medical Center-leake, Inc 1225 N State St Jackson MS 39202-2064 Ph: (601) 968-1000 |
| NPI Number | 1356626618 |
|---|---|
| Provider Enumeration Date | 10/19/2011 |
| Last Update Date | 09/30/2020 |
| Medicare PECOS PAC ID | 7214102961 |
|---|---|
| Medicare Enrollment ID | O20120112000444 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356626618 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| Provider Name | Norman Connell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1659307296 PECOS PAC ID: 6901895655 Enrollment ID: I20040508000382 |
| Provider Name | Tommie K Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023187689 PECOS PAC ID: 7315925591 Enrollment ID: I20040713000919 |
| Provider Name | Charlie M Hardin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669450037 PECOS PAC ID: 8628049681 Enrollment ID: I20040803001282 |
| Provider Name | Manuel Lim Ong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932158664 PECOS PAC ID: 1759350739 Enrollment ID: I20040928000411 |
| Provider Name | Ronnie K Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104860907 PECOS PAC ID: 8527005669 Enrollment ID: I20050411001065 |
| Provider Name | William Douglas Perry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033196977 PECOS PAC ID: 8921901794 Enrollment ID: I20070613000015 |
| Provider Name | Angela T Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407884356 PECOS PAC ID: 0648379149 Enrollment ID: I20070625000419 |
| Provider Name | Meredith Hayles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821220674 PECOS PAC ID: 9133265259 Enrollment ID: I20091005000010 |
| Provider Name | Jenna K Cole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962777896 PECOS PAC ID: 2668634932 Enrollment ID: I20120502000552 |
| Provider Name | Jennifer E Tuccio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871872820 PECOS PAC ID: 3173787967 Enrollment ID: I20120606000665 |
| Provider Name | Linda A Pickering |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881610756 PECOS PAC ID: 6608199856 Enrollment ID: I20141219001714 |
| Provider Name | Ericka C Vaughn |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1598870032 PECOS PAC ID: 3274514906 Enrollment ID: I20141222001684 |
| Provider Name | Constance D Wilkerson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295106326 PECOS PAC ID: 9739480104 Enrollment ID: I20151209002255 |
| Provider Name | Jonathan M Buchanan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073925244 PECOS PAC ID: 5496079386 Enrollment ID: I20160526000989 |
| Provider Name | William B Mckinley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326580820 PECOS PAC ID: 9739462326 Enrollment ID: I20170206000401 |
| Provider Name | Laura K Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386164630 PECOS PAC ID: 3577822972 Enrollment ID: I20180110001878 |
| Provider Name | Kayla B Ferguson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437624566 PECOS PAC ID: 4183978885 Enrollment ID: I20181115002428 |
| Provider Name | Bobbie Evans Mooney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942778311 PECOS PAC ID: 0244570604 Enrollment ID: I20190321000318 |
| Provider Name | Joseph B Tullos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609105196 PECOS PAC ID: 0941326938 Enrollment ID: I20201019000237 |
| Provider Name | Ladaryl Lorraine Watkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760949390 PECOS PAC ID: 3971911454 Enrollment ID: I20210422000171 |
| Provider Name | Shelby Lynne Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538760897 PECOS PAC ID: 8426459330 Enrollment ID: I20210630000158 |
| Provider Name | Ashley Dorman Brian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518668201 PECOS PAC ID: 7911362884 Enrollment ID: I20230427001865 |
Ben W. Seale, M.d., Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 971 Lakeland Dr, Suite 450, Jackson, MS 39216 Phone: 601-948-5158 Fax: 601-949-6058 | |
Central Mississippi Health Services, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3450 Highway 80 W Ste 71, Jackson, MS 39209 Phone: 601-321-2400 | |
Hni Medical Services Of Mississippi, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 969 Lakeland Dr, Jackson, MS 39216 Phone: 601-200-2000 | |
Medical Care Associates Mobile Unit Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3855 Azalea Dr, Jackson, MS 39206 Phone: 601-366-9447 | |
The Wound Care Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1850 Chadwick Dr, Jackson, MS 39204 Phone: 601-376-2561 Fax: 601-376-2570 | |
Quad Intermed Company Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5005 Old Canton Rd, Jackson, MS 39211 Phone: 601-957-3333 | |
Vanessa L. Sandifer, M.d., Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 971 Lakeland Drive, Suite 450, Jackson, MS 39216 Phone: 601-948-5158 Fax: 601-949-6058 |