| New Albany Ob/gyn Clinic Pc | |
|
117 Fairfield Dr New Albany MS 38652-3107 | |
| (662) 534-0029 | |
| Not Available |
| Full Name | New Albany Ob/gyn Clinic Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 117 Fairfield Dr, New Albany, Mississippi |
| Authorized Official Name and Position | Regina Russell (INSURANCE CLERK) |
| Authorized Official Contact | 6625340029 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Albany Ob/gyn Clinic Pc 117 Fairfield Dr New Albany MS 38652-3107 Ph: (662) 534-0029 | New Albany Ob/gyn Clinic Pc 117 Fairfield Dr New Albany MS 38652-3107 Ph: (662) 534-0029 |
| NPI Number | 1851573737 |
|---|---|
| Provider Enumeration Date | 12/03/2007 |
| Last Update Date | 09/23/2008 |
| Medicare PECOS PAC ID | 4880761824 |
|---|---|
| Medicare Enrollment ID | O20080917000552 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851573737 | NPI | - | NPPES |
| 09016189 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Gregory E Mitchell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1861498024 PECOS PAC ID: 0446352264 Enrollment ID: I20070226000583 |
| Provider Name | Amy P Blossom |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1518115971 PECOS PAC ID: 0941377477 Enrollment ID: I20080924000508 |
| Provider Name | Dabney J Hamner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831295807 PECOS PAC ID: 1557594942 Enrollment ID: I20140509001665 |
| Provider Name | Katherine R Blassingame |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104292895 PECOS PAC ID: 0941508410 Enrollment ID: I20160418000035 |
| Provider Name | William Bradford Adkins |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1386630911 PECOS PAC ID: 7416914734 Enrollment ID: I20180223001829 |
| Provider Name | Arie Ceville Shaw |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1821355421 PECOS PAC ID: 0042456501 Enrollment ID: I20180328002860 |
| Provider Name | Garrick J Slate |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1386844702 PECOS PAC ID: 8325110174 Enrollment ID: I20210204000813 |
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