| Phillips Medical Services Pllc | |
|
909 Ellis Ave Ste 16 Jackson MS 39209-6256 | |
| (601) 948-8503 | |
| (601) 948-8502 |
| Full Name | Phillips Medical Services Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 909 Ellis Ave Ste 16, Jackson, Mississippi |
| Authorized Official Name and Position | Tricia Duncan (BILLER) |
| Authorized Official Contact | 6018786945 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phillips Medical Services Pllc 909 Ellis Ave Ste 16 Jackson MS 39209-6256 Ph: (601) 948-8503 | Phillips Medical Services Pllc 909 Ellis Ave Ste 16 Jackson MS 39209-6256 Ph: (601) 948-8503 |
| NPI Number | 1174792790 |
|---|---|
| Provider Enumeration Date | 02/27/2008 |
| Last Update Date | 04/30/2014 |
| Medicare PECOS PAC ID | 2163594540 |
|---|---|
| Medicare Enrollment ID | O20080630000235 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174792790 | NPI | - | NPPES |
| 00116024 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 10785 (Mississippi) | Primary |
| Provider Name | Andrea L Phillips |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558462382 PECOS PAC ID: 2567433345 Enrollment ID: I20040804001213 |
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