Physician Management Services Of Mississippi, Llc | |
1901 Mission 66 Vicksburg MS 39180-3711 | |
(888) 829-8550 | |
Not Available |
Full Name | Physician Management Services Of Mississippi, Llc |
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Speciality | Family Medicine |
Location | 1901 Mission 66, Vicksburg, Mississippi |
Authorized Official Name and Position | Brett Kenefick (PRESIDENT) |
Authorized Official Contact | 8888298550 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Physician Management Services Of Mississippi, Llc 3113 Lawton Rd Ste 250 Orlando FL 32803-3517 Ph: () - | Physician Management Services Of Mississippi, Llc 1901 Mission 66 Vicksburg MS 39180-3711 Ph: (888) 829-8550 |
NPI Number | 1922633916 |
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Provider Enumeration Date | 03/10/2020 |
Last Update Date | 03/10/2020 |
Medicare PECOS PAC ID | 9234552555 |
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Medicare Enrollment ID | O20200706000909 |
Identifier | Type | State | Issuer |
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1922633916 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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