| Parkway Medical Group Inc | |
|
2503 Glendale Ave Hattiesburg MS 39401-1073 | |
| (601) 582-5805 | |
| (601) 582-5806 |
| Full Name | Parkway Medical Group Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2503 Glendale Ave, Hattiesburg, Mississippi |
| Authorized Official Name and Position | Akwasi A Amponsah (CEO/ MEDICAL DIRECTOR) |
| Authorized Official Contact | 6015825805 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Parkway Medical Group Inc 2503 Glendale Ave Hattiesburg MS 39401-1073 Ph: (601) 582-5805 | Parkway Medical Group Inc 2503 Glendale Ave Hattiesburg MS 39401-1073 Ph: (601) 582-5805 |
| NPI Number | 1033366174 |
|---|---|
| Provider Enumeration Date | 08/20/2008 |
| Last Update Date | 08/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033366174 | NPI | - | NPPES |
| 00125127 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 17488 (Mississippi) | Primary |
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