Prentiss Primary Care, P.a. | |
959 Hwy 42 Prentiss MS 39474-1373 | |
(601) 792-3200 | |
(601) 792-3299 |
Full Name | Prentiss Primary Care, P.a. |
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Speciality | Internal Medicine |
Location | 959 Hwy 42, Prentiss, Mississippi |
Authorized Official Name and Position | Jaishankar Jagadeesan (PRESIDENT) |
Authorized Official Contact | 6017923200 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Prentiss Primary Care, P.a. Po Box 1373 Prentiss MS 39474-1373 Ph: (601) 792-3200 | Prentiss Primary Care, P.a. 959 Hwy 42 Prentiss MS 39474-1373 Ph: (601) 792-3200 |
NPI Number | 1902129455 |
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Provider Enumeration Date | 03/11/2010 |
Last Update Date | 03/11/2010 |
Medicare PECOS PAC ID | 5799969465 |
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Medicare Enrollment ID | O20110405000824 |
Identifier | Type | State | Issuer |
---|---|---|---|
1902129455 | NPI | - | NPPES |
09016230 | Medicaid | MS | |
00118344 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 15442 (Mississippi) | Primary |
Provider Name | Jaishankar Jagadeesan |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1326149253 PECOS PAC ID: 9638353394 Enrollment ID: I20110405000768 |
Jefferson Davis Community Hospital Family Practice Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1014 Rose St, Suite A, Prentiss, MS 39474 Phone: 601-792-4276 Fax: 601-792-2947 | |
Jefferson Davis Community Hospital Family Practice Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1150 Berry Street, Prentiss, MS 39474 Phone: 601-792-8432 Fax: 601-792-8453 | |
Family Health Care Clinic, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 910 Second Street, Prentiss, MS 39474 Phone: 601-792-2078 Fax: 601-792-8211 | |
Prentiss Family Practice Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1014 Rose Street, Prentiss, MS 39474 Phone: 601-792-2071 Fax: 601-792-8134 | |
Family Health Care Clinic, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 150 J E Johnson Rd, Prentiss, MS 39474 Phone: 601-825-7280 Fax: 601-825-8130 | |
Jefferson Davis Rural Health Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1014 Rose St, Suite A, Prentiss, MS 39474 Phone: 601-792-2202 Fax: 601-792-2345 | |
Ware Family Practice Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 972 Columbia Ave, Prentiss, MS 39474 Phone: 601-792-5343 |