| North Mississippi Medical Clinics Inc | |
|
450 E President Ave Tupelo MS 38801-5599 | |
| (662) 377-4685 | |
| Not Available |
| Full Name | North Mississippi Medical Clinics Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 450 E President Ave, Tupelo, Mississippi |
| Authorized Official Name and Position | Gerald Kimbrough (MANAGER) |
| Authorized Official Contact | 6623774685 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Mississippi Medical Clinics Inc 450 E President Ave Tupelo MS 38801-5599 Ph: () - | North Mississippi Medical Clinics Inc 450 E President Ave Tupelo MS 38801-5599 Ph: (662) 377-4685 |
| NPI Number | 1053469486 |
|---|---|
| Provider Enumeration Date | 01/08/2007 |
| Last Update Date | 08/06/2013 |
| Medicare PECOS PAC ID | 6103736665 |
|---|---|
| Medicare Enrollment ID | O20040127000582 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053469486 | NPI | - | NPPES |
| CA7889 | Other | MS | RAILROAD MEDICARE GROUP |
| F097 | Other | AL | MEDICARE GROUP |
| I345 | Other | AL | MEDICARE GROUP |
| Provider Name | Thomas S Glasgow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316913783 PECOS PAC ID: 8628966587 Enrollment ID: I20040319000827 |
| Provider Name | Stephen S Hathcock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134221419 PECOS PAC ID: 6002808748 Enrollment ID: I20040401000755 |
| Provider Name | Angela Furr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093817306 PECOS PAC ID: 2062407349 Enrollment ID: I20040416000524 |
| Provider Name | Robert N Stewart |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1932165073 PECOS PAC ID: 6901892090 Enrollment ID: I20040423000301 |
| Provider Name | William R Edmonson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1528031077 PECOS PAC ID: 6002897246 Enrollment ID: I20040525001096 |
| Provider Name | Daryl G Schroader |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700841624 PECOS PAC ID: 2163497421 Enrollment ID: I20040901000713 |
| Provider Name | Charles E Leckie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861461378 PECOS PAC ID: 5799753554 Enrollment ID: I20040920000587 |
| Provider Name | Steven C Brandon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225017239 PECOS PAC ID: 5294704375 Enrollment ID: I20040927000192 |
| Provider Name | Shannon C Fryery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407895725 PECOS PAC ID: 3476522004 Enrollment ID: I20040929001138 |
| Provider Name | Rachel M Rish |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164584223 PECOS PAC ID: 0840237491 Enrollment ID: I20050414000709 |
| Provider Name | Clifton W Story |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922064591 PECOS PAC ID: 0244272607 Enrollment ID: I20050525000851 |
| Provider Name | Steven D Woodward |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1730168196 PECOS PAC ID: 0042256828 Enrollment ID: I20050701000276 |
| Provider Name | David A Reed |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1093826349 PECOS PAC ID: 0648216929 Enrollment ID: I20050708000285 |
| Provider Name | Julie R Palmer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922054477 PECOS PAC ID: 6406882406 Enrollment ID: I20050712000132 |
| Provider Name | Danny D Lantrip |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477594851 PECOS PAC ID: 7517994809 Enrollment ID: I20050719000523 |
| Provider Name | Kunthavai S Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891776530 PECOS PAC ID: 8224065701 Enrollment ID: I20050726001117 |
| Provider Name | Raymond R Arriola |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265404214 PECOS PAC ID: 2466487475 Enrollment ID: I20050928001059 |
| Provider Name | Zandra D Frans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699781765 PECOS PAC ID: 8527075928 Enrollment ID: I20060309000367 |
| Provider Name | Kevin R Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992773535 PECOS PAC ID: 0446267868 Enrollment ID: I20060309000542 |
| Provider Name | John W White |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457364606 PECOS PAC ID: 1658289277 Enrollment ID: I20060403000487 |
| Provider Name | Bernadine C Dixon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902914716 PECOS PAC ID: 6103823141 Enrollment ID: I20061103000389 |
| Provider Name | Rebecca C Northington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376645697 PECOS PAC ID: 9638179096 Enrollment ID: I20070109000071 |
| Provider Name | Christoph S Reynolds |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154343481 PECOS PAC ID: 4789635384 Enrollment ID: I20070220000088 |
| Provider Name | Jacqueline A Fraiser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629199633 PECOS PAC ID: 3577656669 Enrollment ID: I20070905000713 |
| Provider Name | Michael J Gipson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740201078 PECOS PAC ID: 1850485558 Enrollment ID: I20070925000368 |
| Provider Name | Jeff T Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346390093 PECOS PAC ID: 2961501275 Enrollment ID: I20080422000681 |
| Provider Name | Deanna D Coker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255530267 PECOS PAC ID: 5496834608 Enrollment ID: I20080429000791 |
| Provider Name | Jennifer L Thompson-davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639350150 PECOS PAC ID: 8527131747 Enrollment ID: I20080722000385 |
| Provider Name | Julia E Lucius |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1033377767 PECOS PAC ID: 3274607544 Enrollment ID: I20080805000081 |
| Provider Name | Timothy A Albers |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891767687 PECOS PAC ID: 7810061751 Enrollment ID: I20080811000393 |
| Provider Name | Shelley Gaggini |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1437317583 PECOS PAC ID: 2466527353 Enrollment ID: I20080812000209 |
| Provider Name | Marissa O Cruz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316108756 PECOS PAC ID: 7315014362 Enrollment ID: I20080917000583 |
| Provider Name | Katherine B Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861639015 PECOS PAC ID: 1658436167 Enrollment ID: I20090217000622 |
| Provider Name | Paul M Perry |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1689614513 PECOS PAC ID: 7113952953 Enrollment ID: I20090826000809 |
| Provider Name | Bonnie N Basler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851398309 PECOS PAC ID: 6406843259 Enrollment ID: I20091130000245 |
| Provider Name | Vickey M Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063746345 PECOS PAC ID: 5597805671 Enrollment ID: I20091222000090 |
| Provider Name | Mona M Castle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437122751 PECOS PAC ID: 9638213580 Enrollment ID: I20100216000922 |
| Provider Name | Pamela Hodges |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982935623 PECOS PAC ID: 8325175284 Enrollment ID: I20100423000765 |
| Provider Name | Michelle M Turba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912963471 PECOS PAC ID: 9234266883 Enrollment ID: I20100429001226 |
| Provider Name | Charles M King |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1538137989 PECOS PAC ID: 3678601093 Enrollment ID: I20100505000856 |
| Provider Name | Kenneth A Wolfe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114983111 PECOS PAC ID: 4688702046 Enrollment ID: I20100506000198 |
| Provider Name | Charles S Kelly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104895267 PECOS PAC ID: 2163550377 Enrollment ID: I20100510000332 |
| Provider Name | Sharon B Mitchell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306806930 PECOS PAC ID: 8224166442 Enrollment ID: I20100510000368 |
| Provider Name | Gerald A Turner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285630715 PECOS PAC ID: 6507994746 Enrollment ID: I20100510000608 |
| Provider Name | Frank S Fortenberry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811963408 PECOS PAC ID: 9436287539 Enrollment ID: I20100511000788 |
| Provider Name | Melaine W Wallace |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346207222 PECOS PAC ID: 3072641091 Enrollment ID: I20100512001053 |
| Provider Name | Ruben B Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780652057 PECOS PAC ID: 3375671290 Enrollment ID: I20100513000174 |
| Provider Name | Rebekah A Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962464883 PECOS PAC ID: 3870579865 Enrollment ID: I20100519000239 |
| Provider Name | Kenneth R Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831161397 PECOS PAC ID: 1456480060 Enrollment ID: I20100519000902 |
| Provider Name | John G Shields |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1023074101 PECOS PAC ID: 5597894113 Enrollment ID: I20100520000119 |
| Provider Name | Erik W Dukes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124090618 PECOS PAC ID: 7113056748 Enrollment ID: I20100520000148 |
| Provider Name | Terry W Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740249515 PECOS PAC ID: 0042349359 Enrollment ID: I20100525000796 |
| Provider Name | Billy R Walton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710944699 PECOS PAC ID: 9537298591 Enrollment ID: I20100601000232 |
| Provider Name | Thomas M Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093040057 PECOS PAC ID: 7719017326 Enrollment ID: I20100608000758 |
| Provider Name | Winnie S Simmons |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1568428647 PECOS PAC ID: 8921138330 Enrollment ID: I20100611000068 |
| Provider Name | Ronald B Crosswhite |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144486572 PECOS PAC ID: 7719010578 Enrollment ID: I20100729000836 |
| Provider Name | Richmond D Mccarty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487632188 PECOS PAC ID: 1153454988 Enrollment ID: I20100730000784 |
| Provider Name | Donald C Robertson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538297593 PECOS PAC ID: 7214036185 Enrollment ID: I20100816000275 |
| Provider Name | Samuel Newell |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1962495192 PECOS PAC ID: 6608934674 Enrollment ID: I20100903000298 |
| Provider Name | Donna L Harrington |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1093708232 PECOS PAC ID: 1951426394 Enrollment ID: I20100909000161 |
| Provider Name | Mark H Fletcher |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1225021371 PECOS PAC ID: 5890810170 Enrollment ID: I20100909000657 |
| Provider Name | Donald K Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386600427 PECOS PAC ID: 7810189081 Enrollment ID: I20101006000293 |
| Provider Name | Joseph F Jackson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922074806 PECOS PAC ID: 2062604242 Enrollment ID: I20101006000456 |
| Provider Name | Emily M Sesser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295042919 PECOS PAC ID: 5395931067 Enrollment ID: I20101119000628 |
| Provider Name | Benton E Kilman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144457284 PECOS PAC ID: 7214124882 Enrollment ID: I20101208000610 |
| Provider Name | Mary A. Fleming-parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780622712 PECOS PAC ID: 2264328764 Enrollment ID: I20101230000098 |
| Provider Name | Lisa P Sanders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124161849 PECOS PAC ID: 5294827077 Enrollment ID: I20110323000506 |
| Provider Name | Justin C Graff |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427041664 PECOS PAC ID: 4082898986 Enrollment ID: I20110418000118 |
| Provider Name | Leita N Stark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760719447 PECOS PAC ID: 8224215744 Enrollment ID: I20110610000175 |
| Provider Name | Sherry Lynn Finn Gaskin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811289564 PECOS PAC ID: 0840477261 Enrollment ID: I20110610000340 |
| Provider Name | Leslie R Villarrubia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861605560 PECOS PAC ID: 2769665322 Enrollment ID: I20110707000203 |
| Provider Name | Robert Coleman Mceachern |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1164413407 PECOS PAC ID: 0840370268 Enrollment ID: I20110913000051 |
| Provider Name | Tandalaya Meoshye Traylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578851325 PECOS PAC ID: 5799956082 Enrollment ID: I20110916000358 |
| Provider Name | Lauren C Waldrop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467735266 PECOS PAC ID: 8224201025 Enrollment ID: I20111021000455 |
| Provider Name | Rebecca A Mitchener |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710262746 PECOS PAC ID: 4183899859 Enrollment ID: I20111207000513 |
| Provider Name | Lisa G Dabbs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689950040 PECOS PAC ID: 5294902789 Enrollment ID: I20120124000912 |
| Provider Name | Noel V Garcia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053322842 PECOS PAC ID: 3476533480 Enrollment ID: I20120202000889 |
| Provider Name | Deanna Leigh Sanders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295004497 PECOS PAC ID: 2163681180 Enrollment ID: I20120312000493 |
| Provider Name | William T Jennings |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992935266 PECOS PAC ID: 8527221423 Enrollment ID: I20120511000195 |
| Provider Name | Marcus E Ueltschey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447278528 PECOS PAC ID: 2365605276 Enrollment ID: I20120511000301 |
| Provider Name | Kevin W Abel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134356272 PECOS PAC ID: 3375708431 Enrollment ID: I20120625000011 |
| Provider Name | Alisha B. Tenhet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487900098 PECOS PAC ID: 2961653704 Enrollment ID: I20121105000052 |
| Provider Name | Erin M Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730439407 PECOS PAC ID: 8527218361 Enrollment ID: I20130718000557 |
| Provider Name | Susan M Hines |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942255260 PECOS PAC ID: 9234217407 Enrollment ID: I20130723000871 |
| Provider Name | Ashley S Henson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144669649 PECOS PAC ID: 0042454134 Enrollment ID: I20130911000122 |
| Provider Name | Barbrette A Clayborn |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1932409083 PECOS PAC ID: 6507000148 Enrollment ID: I20130920000176 |
| Provider Name | William S Darsey |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1689961914 PECOS PAC ID: 2264667203 Enrollment ID: I20131030000373 |
| Provider Name | Robbie L Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881946465 PECOS PAC ID: 4082849534 Enrollment ID: I20131108001368 |
| Provider Name | Vernon A Rayford |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053548545 PECOS PAC ID: 8527226687 Enrollment ID: I20131227000138 |
| Provider Name | Codi L Hallmark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619305687 PECOS PAC ID: 6204064199 Enrollment ID: I20140123000845 |
| Provider Name | Holly Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336575315 PECOS PAC ID: 0941439442 Enrollment ID: I20140203001455 |
| Provider Name | Whitney Alana Sparks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265865992 PECOS PAC ID: 6406086966 Enrollment ID: I20140228000637 |
| Provider Name | Margaret D Fava |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265854806 PECOS PAC ID: 7113159971 Enrollment ID: I20140409000727 |
| Provider Name | Charles Abavare |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790081156 PECOS PAC ID: 6002048568 Enrollment ID: I20140415001811 |
| Provider Name | Jeffrey S Ballard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841613684 PECOS PAC ID: 9931332897 Enrollment ID: I20140429001707 |
| Provider Name | Dustin L Markle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245529437 PECOS PAC ID: 2860620150 Enrollment ID: I20140919001041 |
| Provider Name | Lakesha J Butler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437561982 PECOS PAC ID: 5092935304 Enrollment ID: I20141009001077 |
| Provider Name | Bobbi M Sanders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396150017 PECOS PAC ID: 7012138324 Enrollment ID: I20141029001355 |
| Provider Name | Amy O Daniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669879003 PECOS PAC ID: 1850616491 Enrollment ID: I20150202002108 |
| Provider Name | Jennifer C Rigdon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215339080 PECOS PAC ID: 9830414960 Enrollment ID: I20150213000306 |
| Provider Name | David V Pizzimenti |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1265517056 PECOS PAC ID: 3173552189 Enrollment ID: I20150504000344 |
| Provider Name | Stephanie H Mccain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437542487 PECOS PAC ID: 2365762887 Enrollment ID: I20150526000881 |
| Provider Name | Justin C Duke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457615601 PECOS PAC ID: 7012229800 Enrollment ID: I20150708000867 |
| Provider Name | Sheila D Gann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750789863 PECOS PAC ID: 6103131719 Enrollment ID: I20150811005406 |
| Provider Name | Billy Michael Chandler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831574888 PECOS PAC ID: 8628384997 Enrollment ID: I20150901001546 |
| Provider Name | John R Browning |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396185765 PECOS PAC ID: 7719296730 Enrollment ID: I20151014000934 |
| Provider Name | Lisa D Foley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801009592 PECOS PAC ID: 2466671110 Enrollment ID: I20151215001554 |
| Provider Name | Kellie J Thornton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851757413 PECOS PAC ID: 9537466487 Enrollment ID: I20160321002303 |
| Provider Name | Edmund M Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689089203 PECOS PAC ID: 0042517666 Enrollment ID: I20160328000378 |
| Provider Name | Rhonda Von Strahl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992177463 PECOS PAC ID: 1254622350 Enrollment ID: I20160621001321 |
| Provider Name | Lakeisha Renae Chism |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750720363 PECOS PAC ID: 6204126014 Enrollment ID: I20160712001047 |
| Provider Name | Meagan Cherry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871945816 PECOS PAC ID: 2365735016 Enrollment ID: I20160719000784 |
| Provider Name | Sara Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851765226 PECOS PAC ID: 0547553059 Enrollment ID: I20160721000390 |
| Provider Name | Lucas Mcelwain |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1952698433 PECOS PAC ID: 9638395429 Enrollment ID: I20160722000135 |
| Provider Name | Ginger Mcmillan-buchanan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073068003 PECOS PAC ID: 6305133109 Enrollment ID: I20160922000381 |
| Provider Name | Adam Paul Clay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265881007 PECOS PAC ID: 0749577096 Enrollment ID: I20160929002038 |
| Provider Name | Rebecca Ann Stanford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679020630 PECOS PAC ID: 8921165671 Enrollment ID: I20161019000542 |
| Provider Name | Brenda Elain Worthey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740651819 PECOS PAC ID: 0840570131 Enrollment ID: I20161202000265 |
| Provider Name | James Hubbard |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1174650956 PECOS PAC ID: 6901713643 Enrollment ID: I20170117000806 |
| Provider Name | Sheri L Patterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891233300 PECOS PAC ID: 9335423730 Enrollment ID: I20170303000033 |
| Provider Name | Jordan Webster Steele |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568843332 PECOS PAC ID: 0143517946 Enrollment ID: I20170327000878 |
| Provider Name | Angel Isabelle Justice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487104675 PECOS PAC ID: 0042596892 Enrollment ID: I20170411001389 |
| Provider Name | Luke J Campbell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043625668 PECOS PAC ID: 5597052654 Enrollment ID: I20170503001318 |
| Provider Name | Salley Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538697172 PECOS PAC ID: 3678841459 Enrollment ID: I20170620001447 |
| Provider Name | Cherita Brown |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1386089274 PECOS PAC ID: 9638306210 Enrollment ID: I20170710000896 |
| Provider Name | Chelsea Wells |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861914699 PECOS PAC ID: 6103197348 Enrollment ID: I20170805000125 |
| Provider Name | Jenna Mordecai |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336699578 PECOS PAC ID: 3971878364 Enrollment ID: I20171011002111 |
| Provider Name | Farris Burns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942750187 PECOS PAC ID: 6204102478 Enrollment ID: I20171017000941 |
| Provider Name | Brittany Sims |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881104784 PECOS PAC ID: 1153697057 Enrollment ID: I20171020000953 |
| Provider Name | Angela Christine Middleton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124382593 PECOS PAC ID: 3971756875 Enrollment ID: I20171213001009 |
| Provider Name | Maegan Gilliland Flynn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548770563 PECOS PAC ID: 9739449208 Enrollment ID: I20180131002164 |
| Provider Name | Shelley Marie Hamblin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053821793 PECOS PAC ID: 0840550091 Enrollment ID: I20180207002097 |
| Provider Name | Kelli Mcgee Plunk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265942288 PECOS PAC ID: 8921368960 Enrollment ID: I20180212002095 |
| Provider Name | Bethany A Cummings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205356870 PECOS PAC ID: 4385907807 Enrollment ID: I20180416002593 |
| Provider Name | Emily L.b. Landrum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639550783 PECOS PAC ID: 5496033664 Enrollment ID: I20180611000322 |
| Provider Name | Janice R Driskell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649756271 PECOS PAC ID: 1153670633 Enrollment ID: I20180816000383 |
| Provider Name | Kellie Grove |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811472681 PECOS PAC ID: 2062766959 Enrollment ID: I20181113000098 |
| Provider Name | Meghan Alford Luter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013357276 PECOS PAC ID: 0840516084 Enrollment ID: I20181114003268 |
| Provider Name | Marian Boykin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497223317 PECOS PAC ID: 1759625940 Enrollment ID: I20181128002585 |
| Provider Name | Haley J Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891279030 PECOS PAC ID: 4385988971 Enrollment ID: I20181210000374 |
| Provider Name | Angela P Reed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841766656 PECOS PAC ID: 4183969462 Enrollment ID: I20181213002810 |
| Provider Name | Jamie Lynn Frick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972088920 PECOS PAC ID: 1557606795 Enrollment ID: I20181217002530 |
| Provider Name | Hollie Waldron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316500887 PECOS PAC ID: 0840533725 Enrollment ID: I20190516000564 |
| Provider Name | Janee' Routh Steele |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669854964 PECOS PAC ID: 9830483171 Enrollment ID: I20190805002581 |
| Provider Name | Mitchell C Moffett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881115707 PECOS PAC ID: 9032481635 Enrollment ID: I20190830001710 |
| Provider Name | Matthew C Dowdy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700370319 PECOS PAC ID: 9537417969 Enrollment ID: I20191113001353 |
| Provider Name | Sneha Pranjal Desai |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1265760508 PECOS PAC ID: 5193956134 Enrollment ID: I20191118002028 |
| Provider Name | Pranjal Harendrabhai Desai |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1265607881 PECOS PAC ID: 6204100688 Enrollment ID: I20191210002773 |
| Provider Name | Megan Mcbrayer Pierce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144879339 PECOS PAC ID: 4688009897 Enrollment ID: I20200116001303 |
| Provider Name | Kathyrn Smith Hilbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093287773 PECOS PAC ID: 7315374535 Enrollment ID: I20200228001547 |
| Provider Name | Cameron D Bonds |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699205989 PECOS PAC ID: 9436421039 Enrollment ID: I20200708001500 |
| Provider Name | William L Morgan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316477607 PECOS PAC ID: 9537439377 Enrollment ID: I20200709000891 |
| Provider Name | Waqas Israr Gilani |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386039683 PECOS PAC ID: 8325461114 Enrollment ID: I20200713001893 |
| Provider Name | Erin L Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205473253 PECOS PAC ID: 0042636987 Enrollment ID: I20200821002179 |
| Provider Name | Lacy Diane Estes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275148967 PECOS PAC ID: 5092133199 Enrollment ID: I20200921003168 |
| Provider Name | Christopher Richard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528449675 PECOS PAC ID: 4082902739 Enrollment ID: I20201120000032 |
| Provider Name | Marlana Lee Mcfarland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730796376 PECOS PAC ID: 3971910076 Enrollment ID: I20210407000381 |
| Provider Name | Kacie C. Hollimon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619531662 PECOS PAC ID: 9830507482 Enrollment ID: I20210420000869 |
| Provider Name | Kaycee Renee Burcham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518464080 PECOS PAC ID: 1850793308 Enrollment ID: I20210707001520 |
| Provider Name | Michael Thompson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184118796 PECOS PAC ID: 3476801358 Enrollment ID: I20210712001334 |
| Provider Name | Nicole Sherice Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003443458 PECOS PAC ID: 3779985569 Enrollment ID: I20210715004314 |
| Provider Name | Zeenat Shameem |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669960589 PECOS PAC ID: 0143577205 Enrollment ID: I20210722000939 |
| Provider Name | Amber W Norris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174029888 PECOS PAC ID: 4183971062 Enrollment ID: I20210728004134 |
| Provider Name | Jessica Suzanne Jensen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013402254 PECOS PAC ID: 3870997208 Enrollment ID: I20210807000197 |
| Provider Name | Britney Williams |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1588160980 PECOS PAC ID: 4082960331 Enrollment ID: I20210818000139 |
| Provider Name | Emalee Gullick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831705565 PECOS PAC ID: 5698171635 Enrollment ID: I20210831001421 |
| Provider Name | Tanya Sanderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457907248 PECOS PAC ID: 1951707140 Enrollment ID: I20210914001899 |
| Provider Name | Jade Elizabeth James |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427728716 PECOS PAC ID: 4486051679 Enrollment ID: I20211001000099 |
| Provider Name | Angela Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568034502 PECOS PAC ID: 8921498247 Enrollment ID: I20211130003302 |
| Provider Name | James Anthony Welker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568423440 PECOS PAC ID: 2466423538 Enrollment ID: I20220111000854 |
| Provider Name | Courtney B Moreland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538762067 PECOS PAC ID: 1254723521 Enrollment ID: I20220118001663 |
| Provider Name | Lori Harris Conn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750955282 PECOS PAC ID: 8325430358 Enrollment ID: I20220124002470 |
| Provider Name | Mylie Kate Beane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194497032 PECOS PAC ID: 3274925243 Enrollment ID: I20220125001335 |
| Provider Name | Akira Keyana Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972110963 PECOS PAC ID: 6002208915 Enrollment ID: I20220126000497 |
| Provider Name | Amanda Jeanette Hulsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447922364 PECOS PAC ID: 0749673580 Enrollment ID: I20220131001582 |
| Provider Name | Kalisa Deann Mickell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013504067 PECOS PAC ID: 7719370402 Enrollment ID: I20220201001225 |
| Provider Name | Rebecca Erin Mckinney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124781240 PECOS PAC ID: 9830582956 Enrollment ID: I20220211001442 |
| Provider Name | Melinda K Osborn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508486804 PECOS PAC ID: 0143613117 Enrollment ID: I20220216000100 |
| Provider Name | Brent Lee Hallmark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093313397 PECOS PAC ID: 0446643308 Enrollment ID: I20220217000989 |
| Provider Name | Lucinda Dobbs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639824543 PECOS PAC ID: 0648665547 Enrollment ID: I20220310002499 |
| Provider Name | Rachel Stephens Nichols |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184371452 PECOS PAC ID: 2466847090 Enrollment ID: I20220318000072 |
| Provider Name | Emily Nicole Earnest |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578237947 PECOS PAC ID: 6507251816 Enrollment ID: I20220324000418 |
| Provider Name | Guadalupe Jisselle Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912659608 PECOS PAC ID: 4587050539 Enrollment ID: I20220331001092 |
| Provider Name | Amber Hollis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780290569 PECOS PAC ID: 5991191876 Enrollment ID: I20220331002423 |
| Provider Name | Libby Carruth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144978982 PECOS PAC ID: 8729475678 Enrollment ID: I20220425001755 |
| Provider Name | Tyler Knox Crosswhite |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437719085 PECOS PAC ID: 8123354149 Enrollment ID: I20220715000109 |
| Provider Name | Forrest Lyon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881254431 PECOS PAC ID: 8022345610 Enrollment ID: I20220715000677 |
| Provider Name | Torey Krause Collier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700446358 PECOS PAC ID: 5193052322 Enrollment ID: I20220723000403 |
| Provider Name | Tommy Wood |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1710008651 PECOS PAC ID: 1153422852 Enrollment ID: I20220907003282 |
| Provider Name | Denaya Conley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952808958 PECOS PAC ID: 4082015995 Enrollment ID: I20221004000504 |
| Provider Name | Danielle Diane Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326768854 PECOS PAC ID: 7113303801 Enrollment ID: I20221004001004 |
| Provider Name | Samantha Jade Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497478812 PECOS PAC ID: 6305212861 Enrollment ID: I20221025001154 |
| Provider Name | Donnie Lovell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710602776 PECOS PAC ID: 9931576048 Enrollment ID: I20221102002077 |
| Provider Name | Kristin Johnston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922722883 PECOS PAC ID: 8921476359 Enrollment ID: I20221116001222 |
| Provider Name | Bonnie Renee' Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013637529 PECOS PAC ID: 4880062777 Enrollment ID: I20221128001056 |
| Provider Name | Alice Claire Ellis Harrelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427772284 PECOS PAC ID: 5294103941 Enrollment ID: I20221130001367 |
| Provider Name | Farelon Elise Randle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730774290 PECOS PAC ID: 3173991767 Enrollment ID: I20221202000762 |
| Provider Name | Bailey Andrew Hansen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912431842 PECOS PAC ID: 8224306006 Enrollment ID: I20221207002242 |
| Provider Name | Jonathan Vinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164143087 PECOS PAC ID: 7315316312 Enrollment ID: I20221214001576 |
| Provider Name | Leah Harris Nabors |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649993957 PECOS PAC ID: 5294105516 Enrollment ID: I20230103001457 |
| Provider Name | Raaj R Ghosal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366066698 PECOS PAC ID: 2860817293 Enrollment ID: I20230717001334 |
| Provider Name | Madison Leggett James |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306439112 PECOS PAC ID: 6901272475 Enrollment ID: I20230719000318 |
| Provider Name | Jarred L Sartain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982754974 PECOS PAC ID: 1557465713 Enrollment ID: I20230731002836 |
| Provider Name | Ethan W Collier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598389702 PECOS PAC ID: 7810312329 Enrollment ID: I20230905002135 |
| Provider Name | Lara Blake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881472371 PECOS PAC ID: 8729435359 Enrollment ID: I20231103001107 |
| Provider Name | Chantelle Harry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285286898 PECOS PAC ID: 4385089507 Enrollment ID: I20240228000222 |
| Provider Name | Susan Olivia Hodges |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588311732 PECOS PAC ID: 4789020421 Enrollment ID: I20240315002477 |
| Provider Name | Kathryn Robertson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760250088 PECOS PAC ID: 4385086784 Enrollment ID: I20240603002144 |
South Madison Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1040a S. Madison St, Tupelo, MS 38801 Phone: 662-377-4685 Fax: 662-377-2755 | |
Nmmc Ekg Interpretations Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 830 S Gloster St, Tupelo, MS 38801 Phone: 662-377-4685 Fax: 662-377-2755 | |
North Mississippi Neurosurgical Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4381 S Eason Blvd, Suite 302, Tupelo, MS 38801 Phone: 662-377-5700 Fax: 662-377-5720 | |
Pontotoc Health Providers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 450 E President Ave, Tupelo, MS 38801 Phone: 662-377-4685 Fax: 662-377-2057 | |
Grant Family Medical Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 805 Varsity Dr, Tupelo, MS 38801 Phone: 484-252-6707 | |
Advanced Wound Center Professionals Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 830 S Gloster St, 1st Floor East Tower, Tupelo, MS 38801 Phone: 662-377-2395 Fax: 662-377-2397 |