Southeastern Transitional Care Management Services | |
13 Westridge Dr Brandon MS 39047-9021 | |
(601) 664-4162 | |
Not Available |
Full Name | Southeastern Transitional Care Management Services |
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Speciality | Family Medicine |
Location | 13 Westridge Dr, Brandon, Mississippi |
Authorized Official Name and Position | John Duke (COO) |
Authorized Official Contact | 6016654162 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Southeastern Transitional Care Management Services 13 Westridge Dr Brandon MS 39047-9021 Ph: (601) 664-4162 | Southeastern Transitional Care Management Services 13 Westridge Dr Brandon MS 39047-9021 Ph: (601) 664-4162 |
NPI Number | 1831807825 |
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Provider Enumeration Date | 11/09/2022 |
Last Update Date | 11/09/2022 |
Medicare PECOS PAC ID | 9830560671 |
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Medicare Enrollment ID | O20230113001844 |
Identifier | Type | State | Issuer |
---|---|---|---|
1831807825 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Christopher John Watkins |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598773897 PECOS PAC ID: 7113925330 Enrollment ID: I20061127000189 |
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