| St. Dominic Medical Associates Llc | |
|
969 Lakeland Dr Jackson MS 39216-4606 | |
| (601) 200-4749 | |
| (601) 200-5929 |
| Full Name | St. Dominic Medical Associates Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 969 Lakeland Dr, Jackson, Mississippi |
| Authorized Official Name and Position | Danielle Stuart (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 6012004880 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Dominic Medical Associates Llc Po Box 23666 Jackson MS 39225-3666 Ph: (601) 200-4749 | St. Dominic Medical Associates Llc 969 Lakeland Dr Jackson MS 39216-4606 Ph: (601) 200-4749 |
| NPI Number | 1407920549 |
|---|---|
| Provider Enumeration Date | 11/20/2006 |
| Last Update Date | 11/18/2021 |
| Medicare PECOS PAC ID | 0446303168 |
|---|---|
| Medicare Enrollment ID | O20090728000821 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407920549 | NPI | - | NPPES |
| Provider Name | Aja A Abai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760492037 PECOS PAC ID: 1355234386 Enrollment ID: I20040204000559 |
| Provider Name | Anne Whitehurst |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1689622318 PECOS PAC ID: 6406740026 Enrollment ID: I20040212000662 |
| Provider Name | Dominic A Jaeger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841361938 PECOS PAC ID: 5193611069 Enrollment ID: I20040226000582 |
| Provider Name | Donald Paul Seago |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1194717363 PECOS PAC ID: 7719876648 Enrollment ID: I20040311000290 |
| Provider Name | Bethany B Case |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508009382 PECOS PAC ID: 3870482144 Enrollment ID: I20040313000694 |
| Provider Name | Shuja Yousuf |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1881643088 PECOS PAC ID: 9133116023 Enrollment ID: I20040430000947 |
| Provider Name | Douglas D Harkins |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1457376915 PECOS PAC ID: 6901895879 Enrollment ID: I20040507000382 |
| Provider Name | Alfred G Lyons |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1932201423 PECOS PAC ID: 3274523097 Enrollment ID: I20040514000061 |
| Provider Name | Shara M Beckwith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609864974 PECOS PAC ID: 8628056595 Enrollment ID: I20040708001048 |
| Provider Name | Mitchell J Myers |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386784239 PECOS PAC ID: 0840279014 Enrollment ID: I20040720000653 |
| Provider Name | John Payne |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760451991 PECOS PAC ID: 1052388782 Enrollment ID: I20040913001074 |
| Provider Name | James E Roberts |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083628291 PECOS PAC ID: 1052373511 Enrollment ID: I20041028000108 |
| Provider Name | Tabitha L Snowdy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477580819 PECOS PAC ID: 8729043005 Enrollment ID: I20041129000441 |
| Provider Name | Clifton W Story |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922064591 PECOS PAC ID: 0244272607 Enrollment ID: I20050525000851 |
| Provider Name | Kenneth Barry Tinsley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700983285 PECOS PAC ID: 3678516325 Enrollment ID: I20050603000834 |
| Provider Name | James G Bennett |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1760426670 PECOS PAC ID: 7911941455 Enrollment ID: I20050615000330 |
| Provider Name | Michelle A Petro |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1679561948 PECOS PAC ID: 3476599564 Enrollment ID: I20050629000280 |
| Provider Name | James K Glisson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245274281 PECOS PAC ID: 8628014453 Enrollment ID: I20050701000697 |
| Provider Name | Harriet L Jones |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184672750 PECOS PAC ID: 1557307188 Enrollment ID: I20050705000641 |
| Provider Name | Rebekah W Moulder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932200151 PECOS PAC ID: 4486682150 Enrollment ID: I20050803000200 |
| Provider Name | Landall C Hathorn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487755617 PECOS PAC ID: 9739117417 Enrollment ID: I20050803000314 |
| Provider Name | Brian S Torrey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356442578 PECOS PAC ID: 2062440746 Enrollment ID: I20050803000355 |
| Provider Name | Catherine D Garner-kuada |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306911797 PECOS PAC ID: 1557391521 Enrollment ID: I20050818000947 |
| Provider Name | Paul E Sheffield |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093783672 PECOS PAC ID: 4385661768 Enrollment ID: I20051025000621 |
| Provider Name | Bobby L Graham |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1205831666 PECOS PAC ID: 8123048618 Enrollment ID: I20051129000770 |
| Provider Name | Gabriel M Zevallos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013965599 PECOS PAC ID: 5890751325 Enrollment ID: I20060208000600 |
| Provider Name | Marc C Hellrung |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366473464 PECOS PAC ID: 9032112909 Enrollment ID: I20060814000549 |
| Provider Name | William H Crowder |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1619919479 PECOS PAC ID: 9739183575 Enrollment ID: I20060908000286 |
| Provider Name | Eric A Mcvey |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1467433995 PECOS PAC ID: 1951296219 Enrollment ID: I20060926000538 |
| Provider Name | Kathleen A Messenger |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1174574701 PECOS PAC ID: 4284637257 Enrollment ID: I20061002000675 |
| Provider Name | Jennifer J Bryan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417976739 PECOS PAC ID: 1850397142 Enrollment ID: I20061010000321 |
| Provider Name | John W Norton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124060033 PECOS PAC ID: 9638106784 Enrollment ID: I20061130000149 |
| Provider Name | James Darnell Mcintyre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114009966 PECOS PAC ID: 3375543903 Enrollment ID: I20070105000137 |
| Provider Name | Cynthia E Allen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679668487 PECOS PAC ID: 3678677804 Enrollment ID: I20070328000472 |
| Provider Name | Jo P Deal |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1003826272 PECOS PAC ID: 1850497397 Enrollment ID: I20070430000681 |
| Provider Name | Arturo E Blanco |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184778508 PECOS PAC ID: 2567568595 Enrollment ID: I20070508000121 |
| Provider Name | Angie S Haraway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790876928 PECOS PAC ID: 0840396792 Enrollment ID: I20070509000428 |
| Provider Name | John Adrian Lancon |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1013008242 PECOS PAC ID: 1557467412 Enrollment ID: I20070509000547 |
| Provider Name | John C Funkhouser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821292046 PECOS PAC ID: 3678666195 Enrollment ID: I20070829000572 |
| Provider Name | Keith D Thorne |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1467559476 PECOS PAC ID: 8729171905 Enrollment ID: I20070904000412 |
| Provider Name | Kathy Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508950502 PECOS PAC ID: 6800989765 Enrollment ID: I20070907000755 |
| Provider Name | Stephen C Hammack |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639396393 PECOS PAC ID: 5698868560 Enrollment ID: I20070908000084 |
| Provider Name | Christopher D Boston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295932390 PECOS PAC ID: 9032204870 Enrollment ID: I20071009000271 |
| Provider Name | Robert K Anderson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134280407 PECOS PAC ID: 1052406808 Enrollment ID: I20071009000346 |
| Provider Name | Ruth K Fredericks |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730138843 PECOS PAC ID: 7012947476 Enrollment ID: I20071107000197 |
| Provider Name | Jinna M Shepherd |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497789879 PECOS PAC ID: 7416046073 Enrollment ID: I20071204000660 |
| Provider Name | Rathel L Nolan |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1629004502 PECOS PAC ID: 1759470180 Enrollment ID: I20071207000483 |
| Provider Name | Olatunji Jonathan Oluwatade |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1477677458 PECOS PAC ID: 8628158326 Enrollment ID: I20080115000320 |
| Provider Name | Melanie P Coker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376609990 PECOS PAC ID: 3274617998 Enrollment ID: I20080219000791 |
| Provider Name | Jennifer F Rhea |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568651289 PECOS PAC ID: 1153405550 Enrollment ID: I20080225000131 |
| Provider Name | Teri O Dyess |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1235201302 PECOS PAC ID: 4880770973 Enrollment ID: I20080331000081 |
| Provider Name | John C Farmer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891727640 PECOS PAC ID: 9234108267 Enrollment ID: I20080429000708 |
| Provider Name | David R Young |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1366487365 PECOS PAC ID: 1951313287 Enrollment ID: I20080527000361 |
| Provider Name | Vernon Reid Cotten |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1164466082 PECOS PAC ID: 4688686918 Enrollment ID: I20080527000415 |
| Provider Name | Richard D Guynes |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1770526568 PECOS PAC ID: 9133131469 Enrollment ID: I20080527000427 |
| Provider Name | James Clay Hays |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1912943945 PECOS PAC ID: 9931278389 Enrollment ID: I20080527000434 |
| Provider Name | Jimmy W Lott |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1548206717 PECOS PAC ID: 1052323383 Enrollment ID: I20080527000445 |
| Provider Name | David H Mulholland |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1578509501 PECOS PAC ID: 3779595004 Enrollment ID: I20080527000456 |
| Provider Name | Reuben H Stone |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1326082231 PECOS PAC ID: 8224040555 Enrollment ID: I20080527000464 |
| Provider Name | J Scott Harrison |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003841073 PECOS PAC ID: 9638172968 Enrollment ID: I20080605000305 |
| Provider Name | James L Warnock |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1356360119 PECOS PAC ID: 1254415698 Enrollment ID: I20080708000362 |
| Provider Name | Michelle V Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093888539 PECOS PAC ID: 4082787320 Enrollment ID: I20080721000454 |
| Provider Name | Jason K Taylor |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1649481607 PECOS PAC ID: 5597830042 Enrollment ID: I20080818000401 |
| Provider Name | John D Richardson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144230038 PECOS PAC ID: 2668547993 Enrollment ID: I20080820000487 |
| Provider Name | William Harper |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1225145212 PECOS PAC ID: 7517032790 Enrollment ID: I20080822000379 |
| Provider Name | Zachary K Baldwin |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1487778239 PECOS PAC ID: 1759458896 Enrollment ID: I20080916000194 |
| Provider Name | Alfredo H Figueroa |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1134236128 PECOS PAC ID: 0840367405 Enrollment ID: I20080923000680 |
| Provider Name | Sagar H Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386725570 PECOS PAC ID: 8325115959 Enrollment ID: I20080924000391 |
| Provider Name | Ronald E Kennedy |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1689725202 PECOS PAC ID: 9436210499 Enrollment ID: I20081209000448 |
| Provider Name | Lelouise T Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033361233 PECOS PAC ID: 7315009412 Enrollment ID: I20081226000096 |
| Provider Name | Xiaohong Si |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801089347 PECOS PAC ID: 8921158833 Enrollment ID: I20090616000365 |
| Provider Name | John M Runnels |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1215149711 PECOS PAC ID: 8628129442 Enrollment ID: I20090707000508 |
| Provider Name | Steven S Anthony |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245474998 PECOS PAC ID: 7911050802 Enrollment ID: I20090724000176 |
| Provider Name | Albert W Steele |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588771455 PECOS PAC ID: 2860545506 Enrollment ID: I20090729000059 |
| Provider Name | George E Patton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003914813 PECOS PAC ID: 9032262779 Enrollment ID: I20090729000069 |
| Provider Name | John G Biggs |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992803779 PECOS PAC ID: 4284787920 Enrollment ID: I20090729000099 |
| Provider Name | David M Sullivan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386751329 PECOS PAC ID: 7719030451 Enrollment ID: I20090729000123 |
| Provider Name | Scott C Layne |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922106749 PECOS PAC ID: 6608929344 Enrollment ID: I20090729000140 |
| Provider Name | Ralph Sulser |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184631293 PECOS PAC ID: 1951481878 Enrollment ID: I20090729000203 |
| Provider Name | Beverly C Fulcher |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1184703118 PECOS PAC ID: 7416002555 Enrollment ID: I20090826000226 |
| Provider Name | Kyle F Gordon |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1811076938 PECOS PAC ID: 4789739772 Enrollment ID: I20090826000785 |
| Provider Name | Bryan M Clay |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1730268764 PECOS PAC ID: 9133274129 Enrollment ID: I20090826000802 |
| Provider Name | Paul B Kerr |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1518197151 PECOS PAC ID: 8325184781 Enrollment ID: I20091015000393 |
| Provider Name | Ujjwal Dhar |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1841223377 PECOS PAC ID: 9234121633 Enrollment ID: I20091110000476 |
| Provider Name | Bobby Proctor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801006960 PECOS PAC ID: 7315018579 Enrollment ID: I20091116000037 |
| Provider Name | Amanda L Atwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942431200 PECOS PAC ID: 7214076652 Enrollment ID: I20091125000110 |
| Provider Name | Julia S Bruce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720275753 PECOS PAC ID: 2062551328 Enrollment ID: I20091125000363 |
| Provider Name | Tracy B Rhinewalt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285967547 PECOS PAC ID: 1052451846 Enrollment ID: I20091230000176 |
| Provider Name | Kimberly Loe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881928315 PECOS PAC ID: 3375685068 Enrollment ID: I20100119000154 |
| Provider Name | William H Wooten |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770511420 PECOS PAC ID: 3971648858 Enrollment ID: I20100303000358 |
| Provider Name | Vicki Mcneal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750618468 PECOS PAC ID: 3577694512 Enrollment ID: I20100708000308 |
| Provider Name | Jericho L Bell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811194772 PECOS PAC ID: 3274665674 Enrollment ID: I20100721000261 |
| Provider Name | Eric Christopher Evans |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871791434 PECOS PAC ID: 6800929654 Enrollment ID: I20100802000022 |
| Provider Name | Pierce Dotherow |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1346238615 PECOS PAC ID: 6709882368 Enrollment ID: I20100810000232 |
| Provider Name | Reed Hogan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1023006293 PECOS PAC ID: 2769493535 Enrollment ID: I20100811000332 |
| Provider Name | Vonda Gail Reeves |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1194713529 PECOS PAC ID: 3971509530 Enrollment ID: I20100817001267 |
| Provider Name | Mark Edward Wilson |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1184612368 PECOS PAC ID: 0244236800 Enrollment ID: I20100818000060 |
| Provider Name | Cynthia Haden Wright |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1417945668 PECOS PAC ID: 7517963176 Enrollment ID: I20100818000282 |
| Provider Name | Paul Milner |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1356339782 PECOS PAC ID: 1254337819 Enrollment ID: I20100818000300 |
| Provider Name | James A Underwood |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1447240494 PECOS PAC ID: 5799781357 Enrollment ID: I20100818000370 |
| Provider Name | Odessa Simon Hawkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336273572 PECOS PAC ID: 7012042328 Enrollment ID: I20100827000785 |
| Provider Name | David Glen Mchenry |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053494831 PECOS PAC ID: 1456492131 Enrollment ID: I20101006000627 |
| Provider Name | Heather M Kuriger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609181882 PECOS PAC ID: 2668668542 Enrollment ID: I20101118000767 |
| Provider Name | Richard Larry Russell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063584175 PECOS PAC ID: 2365630977 Enrollment ID: I20101227000376 |
| Provider Name | Ronald Peter Kotfila |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1942298120 PECOS PAC ID: 8527064187 Enrollment ID: I20101228000393 |
| Provider Name | Kenneth Brent Cain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306869102 PECOS PAC ID: 0345229076 Enrollment ID: I20110110000070 |
| Provider Name | Shirley S. Donelson |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1669543120 PECOS PAC ID: 6901095215 Enrollment ID: I20110118000467 |
| Provider Name | Byron Kendall Herpich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164629515 PECOS PAC ID: 6002931839 Enrollment ID: I20110128000153 |
| Provider Name | Margaret M Prasanna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093033656 PECOS PAC ID: 1355522046 Enrollment ID: I20110301000669 |
| Provider Name | Robert Lockhart Saulters |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659443711 PECOS PAC ID: 7618159377 Enrollment ID: I20110316001045 |
| Provider Name | Makau P. Lee |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1093887259 PECOS PAC ID: 7618150921 Enrollment ID: I20110324000230 |
| Provider Name | Carolyn D Coleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770897860 PECOS PAC ID: 4880877802 Enrollment ID: I20110328000819 |
| Provider Name | Michael Morgan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386716553 PECOS PAC ID: 0446433353 Enrollment ID: I20110330000063 |
| Provider Name | Reginald Willis Martin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1679692396 PECOS PAC ID: 0941484737 Enrollment ID: I20110401000377 |
| Provider Name | Donald Page Brannan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1568533198 PECOS PAC ID: 2365626660 Enrollment ID: I20110412000130 |
| Provider Name | Charles E Hall |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1568534832 PECOS PAC ID: 2769669605 Enrollment ID: I20110602000173 |
| Provider Name | Inderpreet Grover |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730390600 PECOS PAC ID: 2769660398 Enrollment ID: I20110629000397 |
| Provider Name | Jess C Roberts |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1336393891 PECOS PAC ID: 8527237494 Enrollment ID: I20110810000186 |
| Provider Name | Lauren Caraway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821376690 PECOS PAC ID: 1052580768 Enrollment ID: I20110815000826 |
| Provider Name | Pierre De Delva |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1043294432 PECOS PAC ID: 6305028747 Enrollment ID: I20110824000308 |
| Provider Name | Bryan A Gaspard |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1598043143 PECOS PAC ID: 4789855966 Enrollment ID: I20110920000204 |
| Provider Name | Leslie A Haines |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831295237 PECOS PAC ID: 2466452818 Enrollment ID: I20110926000423 |
| Provider Name | Joann Haynes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053630806 PECOS PAC ID: 5890966642 Enrollment ID: I20110927000694 |
| Provider Name | Kristina D Vaughn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174770168 PECOS PAC ID: 3577735802 Enrollment ID: I20111011000367 |
| Provider Name | Alicia C Wells |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1699058420 PECOS PAC ID: 1355514829 Enrollment ID: I20111027000715 |
| Provider Name | Lajuana Yevette Newton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144518515 PECOS PAC ID: 3173796554 Enrollment ID: I20111031000378 |
| Provider Name | Janice Bradshaw |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1790068526 PECOS PAC ID: 2961675343 Enrollment ID: I20111031000407 |
| Provider Name | Tiffany A Scarff |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1184810012 PECOS PAC ID: 7113193574 Enrollment ID: I20120105000919 |
| Provider Name | Stella S Culliver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821365511 PECOS PAC ID: 1658547815 Enrollment ID: I20120110000574 |
| Provider Name | Natalie W Moody |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740563543 PECOS PAC ID: 7214195593 Enrollment ID: I20120215000617 |
| Provider Name | Ann E Lutken |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811213853 PECOS PAC ID: 0042478935 Enrollment ID: I20120223000451 |
| Provider Name | Felicie Gretchen Wyatt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740370261 PECOS PAC ID: 8123211463 Enrollment ID: I20120320000231 |
| Provider Name | Ronald D Davis |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1255351367 PECOS PAC ID: 5799945630 Enrollment ID: I20120329000620 |
| Provider Name | Felix Gordon, Jr. |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1780604819 PECOS PAC ID: 0941460893 Enrollment ID: I20120329000801 |
| Provider Name | Brandy C Welch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629355342 PECOS PAC ID: 2668636556 Enrollment ID: I20120605000375 |
| Provider Name | Ernest S Weeks |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1134330822 PECOS PAC ID: 6204092489 Enrollment ID: I20120717000385 |
| Provider Name | Jane Claire B Williams |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1578760534 PECOS PAC ID: 2163685124 Enrollment ID: I20120725000376 |
| Provider Name | Stephen Keith Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174707368 PECOS PAC ID: 3274778618 Enrollment ID: I20130405000425 |
| Provider Name | Alysia M Byers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770824476 PECOS PAC ID: 2961642475 Enrollment ID: I20130705000272 |
| Provider Name | Jeffrey B Mccrary |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1245438860 PECOS PAC ID: 6204077472 Enrollment ID: I20130731000060 |
| Provider Name | Charles Butler |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1164741153 PECOS PAC ID: 8820230196 Enrollment ID: I20130815000737 |
| Provider Name | Emmanuel Okolo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629316609 PECOS PAC ID: 8022206416 Enrollment ID: I20130913000546 |
| Provider Name | Amaleswari Pamarthy |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1265745459 PECOS PAC ID: 5193975753 Enrollment ID: I20131127000425 |
| Provider Name | Sarah K Beasley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689003873 PECOS PAC ID: 5193954477 Enrollment ID: I20140207000728 |
| Provider Name | Vern Antoine Keller |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1639176472 PECOS PAC ID: 0648287029 Enrollment ID: I20140331001784 |
| Provider Name | Nicole F Drahuschak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144518788 PECOS PAC ID: 9537330162 Enrollment ID: I20140508001378 |
| Provider Name | Brett Ashley Bennett |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1538471842 PECOS PAC ID: 2769605310 Enrollment ID: I20140529000200 |
| Provider Name | Reed Blanchard Hogan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1356504682 PECOS PAC ID: 5294998910 Enrollment ID: I20140805000727 |
| Provider Name | Tina M Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902812324 PECOS PAC ID: 7416175278 Enrollment ID: I20140820001868 |
| Provider Name | Seth Compton |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1043449598 PECOS PAC ID: 2466670765 Enrollment ID: I20140828001161 |
| Provider Name | Kelli E Pruitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285049254 PECOS PAC ID: 2264651546 Enrollment ID: I20140918001483 |
| Provider Name | Imad Tahboub |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669468336 PECOS PAC ID: 9436142866 Enrollment ID: I20140923000274 |
| Provider Name | Jill T Easley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891100970 PECOS PAC ID: 4688893613 Enrollment ID: I20140924000240 |
| Provider Name | Lan Zhou |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881953693 PECOS PAC ID: 8426278441 Enrollment ID: I20140925000947 |
| Provider Name | Todd Allen Cumbie |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1679777585 PECOS PAC ID: 2860656659 Enrollment ID: I20141007001973 |
| Provider Name | Syed B Sadiq |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639309685 PECOS PAC ID: 8224250147 Enrollment ID: I20141110000900 |
| Provider Name | Rachael J Wilbanks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134523830 PECOS PAC ID: 3274855374 Enrollment ID: I20141126001645 |
| Provider Name | Latasha M Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780089649 PECOS PAC ID: 2961725056 Enrollment ID: I20141222000886 |
| Provider Name | Bobby Tullos |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1841554250 PECOS PAC ID: 7517280647 Enrollment ID: I20141222002414 |
| Provider Name | Lacey M Hilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427473172 PECOS PAC ID: 2961726393 Enrollment ID: I20150113001815 |
| Provider Name | Shonna P Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699177634 PECOS PAC ID: 5597089482 Enrollment ID: I20150126000125 |
| Provider Name | Justin L Cole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588053052 PECOS PAC ID: 9436474061 Enrollment ID: I20150202001935 |
| Provider Name | Clinton Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124417761 PECOS PAC ID: 7719203769 Enrollment ID: I20150310000938 |
| Provider Name | Abdeen Rihan Farah Musa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568637627 PECOS PAC ID: 8921170630 Enrollment ID: I20150313000272 |
| Provider Name | Brittany Shaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073905923 PECOS PAC ID: 8426375106 Enrollment ID: I20150317001190 |
| Provider Name | Lauren Whitton Buffington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437541109 PECOS PAC ID: 8628395621 Enrollment ID: I20150401001875 |
| Provider Name | Emily C Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750799300 PECOS PAC ID: 7618295023 Enrollment ID: I20150415001883 |
| Provider Name | Amy W Easley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720485600 PECOS PAC ID: 6709106479 Enrollment ID: I20150520000920 |
| Provider Name | Naomi Pauline Vanderford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972932002 PECOS PAC ID: 6002137932 Enrollment ID: I20150604000596 |
| Provider Name | Kristie Usry Callahan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093129231 PECOS PAC ID: 2769794528 Enrollment ID: I20150708000180 |
| Provider Name | Melinda Engel |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1336471119 PECOS PAC ID: 4880907476 Enrollment ID: I20150727000552 |
| Provider Name | Shanna Pettie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093978918 PECOS PAC ID: 3375772072 Enrollment ID: I20150805007147 |
| Provider Name | Angela B Mccallum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659755676 PECOS PAC ID: 4789990284 Enrollment ID: I20150828001492 |
| Provider Name | Bharat Kumar Malhotra |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1992050991 PECOS PAC ID: 4789832437 Enrollment ID: I20150831002203 |
| Provider Name | Misty Stricklin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922486398 PECOS PAC ID: 2365759073 Enrollment ID: I20150914000373 |
| Provider Name | Derek Thomas Hansen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194089581 PECOS PAC ID: 7517275464 Enrollment ID: I20150928000249 |
| Provider Name | Jenna Elizabeth Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104201649 PECOS PAC ID: 6103134077 Enrollment ID: I20150928000879 |
| Provider Name | Audrey Leigh Upchurch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841698792 PECOS PAC ID: 2264740596 Enrollment ID: I20151006000786 |
| Provider Name | Misty Nicole Gaines |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932576998 PECOS PAC ID: 8325357742 Enrollment ID: I20151024000139 |
| Provider Name | Dino Robert Phillippi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841551496 PECOS PAC ID: 1759511025 Enrollment ID: I20151103001188 |
| Provider Name | Bryce Kincaid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265809685 PECOS PAC ID: 2163732736 Enrollment ID: I20151111000588 |
| Provider Name | Mohamed Elhassan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669797940 PECOS PAC ID: 1850525916 Enrollment ID: I20151114000135 |
| Provider Name | Tiffany Melvena Griffin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013302082 PECOS PAC ID: 4587964804 Enrollment ID: I20151118001328 |
| Provider Name | Ajay R Vongala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194089508 PECOS PAC ID: 9133429764 Enrollment ID: I20151203000378 |
| Provider Name | Sandhya R Bogi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1306167788 PECOS PAC ID: 0345493797 Enrollment ID: I20151218000476 |
| Provider Name | Andrea King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699189571 PECOS PAC ID: 2264733799 Enrollment ID: I20151229000190 |
| Provider Name | Pamela D Hardin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174902134 PECOS PAC ID: 6709188642 Enrollment ID: I20160108000797 |
| Provider Name | Summer Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538558473 PECOS PAC ID: 5799087425 Enrollment ID: I20160112001379 |
| Provider Name | Kelli Conwill Cranford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528431145 PECOS PAC ID: 8628371705 Enrollment ID: I20160122002129 |
| Provider Name | Chinemerem Yvonne Ugorji |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316261910 PECOS PAC ID: 1759693013 Enrollment ID: I20160303001265 |
| Provider Name | Jesse Jonathan Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477923241 PECOS PAC ID: 8628375565 Enrollment ID: I20160321001995 |
| Provider Name | Constance Mcmillan Harthcock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841665494 PECOS PAC ID: 2466751581 Enrollment ID: I20160425000738 |
| Provider Name | Stewart A Boyd |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1194954578 PECOS PAC ID: 1658597430 Enrollment ID: I20160516000072 |
| Provider Name | Christen Lynel Walters |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1962639104 PECOS PAC ID: 8628240702 Enrollment ID: I20160714000281 |
| Provider Name | Joel Nutt |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1265720791 PECOS PAC ID: 0941526891 Enrollment ID: I20160727001978 |
| Provider Name | Deidra Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033585286 PECOS PAC ID: 7618260647 Enrollment ID: I20160727002573 |
| Provider Name | Jacob Moremen |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1972743797 PECOS PAC ID: 8729234943 Enrollment ID: I20160809002000 |
| Provider Name | Meghan Page Poole |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114281680 PECOS PAC ID: 2466747746 Enrollment ID: I20160825001340 |
| Provider Name | Hannah Neely White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407207640 PECOS PAC ID: 4284929423 Enrollment ID: I20160826000296 |
| Provider Name | Douglas Allen Tucker |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1043574445 PECOS PAC ID: 7810213659 Enrollment ID: I20160913002675 |
| Provider Name | Ryan Mcgaughey |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1770847154 PECOS PAC ID: 4284953639 Enrollment ID: I20160917000019 |
| Provider Name | Anuj Marya |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093155376 PECOS PAC ID: 3870817661 Enrollment ID: I20161108000910 |
| Provider Name | Laurie Foster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962854323 PECOS PAC ID: 5991085458 Enrollment ID: I20161130000094 |
| Provider Name | Philip B Paine |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255642815 PECOS PAC ID: 8921249962 Enrollment ID: I20161230000254 |
| Provider Name | Kaylon Andrea Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073055695 PECOS PAC ID: 1557642485 Enrollment ID: I20170106001740 |
| Provider Name | Jordan Eiland Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932641255 PECOS PAC ID: 9638451966 Enrollment ID: I20170123001199 |
| Provider Name | Lisa Keeling |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932460508 PECOS PAC ID: 3577702810 Enrollment ID: I20170126002379 |
| Provider Name | Catherine Figueroa Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184162752 PECOS PAC ID: 8628352853 Enrollment ID: I20170307000280 |
| Provider Name | Jared K Taylor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154686541 PECOS PAC ID: 1355657305 Enrollment ID: I20170405002281 |
| Provider Name | Rebecca Little |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578019808 PECOS PAC ID: 2567748122 Enrollment ID: I20170413001526 |
| Provider Name | Scotie Ledford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922544915 PECOS PAC ID: 1355628520 Enrollment ID: I20170426001996 |
| Provider Name | Ralph Brooks Vance |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1487974192 PECOS PAC ID: 2466745658 Enrollment ID: I20170519000776 |
| Provider Name | Rachael Cade Stegall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093260150 PECOS PAC ID: 1759659014 Enrollment ID: I20170612000005 |
| Provider Name | Ollie Demarre Jones |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1265725758 PECOS PAC ID: 3476821547 Enrollment ID: I20170613002471 |
| Provider Name | Adam Nicholas Protos |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1629383922 PECOS PAC ID: 8325277007 Enrollment ID: I20170802001574 |
| Provider Name | Jenetta Anne Thompson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1952665325 PECOS PAC ID: 5799002432 Enrollment ID: I20170810001784 |
| Provider Name | John Michael Barnard |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639599608 PECOS PAC ID: 0941572473 Enrollment ID: I20170818000197 |
| Provider Name | Austin Chandler Nicholson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134532450 PECOS PAC ID: 9638443567 Enrollment ID: I20170915002396 |
| Provider Name | Kelli Potter Brister |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366954240 PECOS PAC ID: 7517224892 Enrollment ID: I20171121001316 |
| Provider Name | Sheena Renell Smoot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982122552 PECOS PAC ID: 6800154238 Enrollment ID: I20171213000280 |
| Provider Name | Kori Yerivan Mcdaniel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255740791 PECOS PAC ID: 5193084598 Enrollment ID: I20180110001097 |
| Provider Name | Jeffrey Allen Kitchens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194225581 PECOS PAC ID: 2264793777 Enrollment ID: I20180226001045 |
| Provider Name | William Angus Rigby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871097626 PECOS PAC ID: 5698038040 Enrollment ID: I20180417001447 |
| Provider Name | Melissa Fowler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477057370 PECOS PAC ID: 9234492414 Enrollment ID: I20180423000880 |
| Provider Name | Jennifer R Dinning |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1699062208 PECOS PAC ID: 4981968435 Enrollment ID: I20180509000145 |
| Provider Name | Gregory Alphonse Redmann |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801822317 PECOS PAC ID: 4880757434 Enrollment ID: I20180514000031 |
| Provider Name | Jonathan Davison Reves |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053705764 PECOS PAC ID: 0840578100 Enrollment ID: I20180620002645 |
| Provider Name | Marshall Adams Briscoe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710374038 PECOS PAC ID: 8224383948 Enrollment ID: I20180621001130 |
| Provider Name | Sarah Gayle Oliver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538677331 PECOS PAC ID: 9537415922 Enrollment ID: I20180627000193 |
| Provider Name | Ragen Layne Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710472758 PECOS PAC ID: 1557619988 Enrollment ID: I20180801002495 |
| Provider Name | Kayla Murphy Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215422480 PECOS PAC ID: 8921356122 Enrollment ID: I20180803002052 |
| Provider Name | Melissa Barham Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578049276 PECOS PAC ID: 6406104199 Enrollment ID: I20180813003005 |
| Provider Name | Huiling Liu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346637493 PECOS PAC ID: 0446501118 Enrollment ID: I20180919000320 |
| Provider Name | Melissa Pender |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063989036 PECOS PAC ID: 2264777887 Enrollment ID: I20181228001806 |
| Provider Name | Ryane P Doty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528531985 PECOS PAC ID: 6901144187 Enrollment ID: I20190213002056 |
| Provider Name | Felecia D Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891253811 PECOS PAC ID: 6800136078 Enrollment ID: I20190326001176 |
| Provider Name | Samuel Hammond Love |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013273259 PECOS PAC ID: 4183853922 Enrollment ID: I20190430001166 |
| Provider Name | Deidre Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730743329 PECOS PAC ID: 6901139526 Enrollment ID: I20190612003598 |
| Provider Name | Jing Yuan Ma |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1831532746 PECOS PAC ID: 8123246295 Enrollment ID: I20190618001163 |
| Provider Name | Kristine Alison Watson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588225775 PECOS PAC ID: 9931435906 Enrollment ID: I20190729002558 |
| Provider Name | Xin Qi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427442391 PECOS PAC ID: 2163739723 Enrollment ID: I20190802001224 |
| Provider Name | Molly Grubbs Mayhugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093201980 PECOS PAC ID: 7416284922 Enrollment ID: I20190806004188 |
| Provider Name | Cassandra L Kingston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144714353 PECOS PAC ID: 2567799679 Enrollment ID: I20190813001362 |
| Provider Name | Vineeth-joseph John Sankoorikal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396199840 PECOS PAC ID: 6800184102 Enrollment ID: I20190924000444 |
| Provider Name | James Vaulx Fussell |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1902290950 PECOS PAC ID: 3375849177 Enrollment ID: I20191009000921 |
| Provider Name | Chassity N Vanderford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427607688 PECOS PAC ID: 5294167037 Enrollment ID: I20191115000761 |
| Provider Name | Stephanie Oberhousen Boydston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356984462 PECOS PAC ID: 7719311778 Enrollment ID: I20191227000855 |
| Provider Name | Emily Harbarger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568020675 PECOS PAC ID: 9032544416 Enrollment ID: I20200113000935 |
| Provider Name | Ashley Fitzhugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356980817 PECOS PAC ID: 2668808205 Enrollment ID: I20200130001349 |
| Provider Name | Olivia Burch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982247888 PECOS PAC ID: 7214363431 Enrollment ID: I20200207000151 |
| Provider Name | Ahtshamullah Chaudhry |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1235650300 PECOS PAC ID: 6002230661 Enrollment ID: I20200716000712 |
| Provider Name | Gabriel Mahasi Buluku |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1174076749 PECOS PAC ID: 6709202682 Enrollment ID: I20200824000665 |
| Provider Name | David Theodoro |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1073518577 PECOS PAC ID: 4789578238 Enrollment ID: I20200831002412 |
| Provider Name | Sharon Henrikson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679186407 PECOS PAC ID: 4183043011 Enrollment ID: I20200928000162 |
| Provider Name | Jawad Noor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083137228 PECOS PAC ID: 1759701303 Enrollment ID: I20201020001863 |
| Provider Name | Christian Fortenberry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003415266 PECOS PAC ID: 1355751868 Enrollment ID: I20201111001250 |
| Provider Name | Danielle Parker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245743269 PECOS PAC ID: 0244641900 Enrollment ID: I20201201002649 |
| Provider Name | Caitlyn Reed |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1982139184 PECOS PAC ID: 6608149901 Enrollment ID: I20210623001669 |
| Provider Name | Kathleen Michele Tate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922614171 PECOS PAC ID: 4789085986 Enrollment ID: I20210625000467 |
| Provider Name | Lauren Williamson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912430935 PECOS PAC ID: 9830462241 Enrollment ID: I20210707000114 |
| Provider Name | John Calhoun |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1275943037 PECOS PAC ID: 3577894518 Enrollment ID: I20210726000226 |
| Provider Name | Brittany N Boykin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053993865 PECOS PAC ID: 5496143414 Enrollment ID: I20211025001984 |
| Provider Name | Nakesia Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063005874 PECOS PAC ID: 0547653644 Enrollment ID: I20220323001398 |
| Provider Name | Ruchika S Yusufji |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659582963 PECOS PAC ID: 1052585916 Enrollment ID: I20220720000382 |
| Provider Name | Jewelian A Baig |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1003376369 PECOS PAC ID: 9830577238 Enrollment ID: I20220803000799 |
| Provider Name | Shannon Murtagh |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1962138487 PECOS PAC ID: 9739563412 Enrollment ID: I20220830000074 |
| Provider Name | Margaux Noel Antoine |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1215662887 PECOS PAC ID: 9638553100 Enrollment ID: I20220901000290 |
| Provider Name | Navkiran Jagdev |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1528623212 PECOS PAC ID: 3870925340 Enrollment ID: I20220901002726 |
| Provider Name | Swathi Muthyam Mogulla |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1831682269 PECOS PAC ID: 3476893074 Enrollment ID: I20220921001271 |
| Provider Name | Olivia Day Leber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396486551 PECOS PAC ID: 3971989252 Enrollment ID: I20221011000712 |
| Provider Name | Virginia Caitlin Gill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558097444 PECOS PAC ID: 7113395914 Enrollment ID: I20221129002382 |
| Provider Name | Jennifer Hume Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093316952 PECOS PAC ID: 0941670665 Enrollment ID: I20221221001248 |
| Provider Name | Anita Choudhary |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1518499102 PECOS PAC ID: 0143599415 Enrollment ID: I20230106002317 |
| Provider Name | Mrinal Shukla |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1912297557 PECOS PAC ID: 1355646159 Enrollment ID: I20230405001351 |
| Provider Name | Parker Ellison |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1760911598 PECOS PAC ID: 5890061949 Enrollment ID: I20230718003029 |
| Provider Name | Steven Arbogast |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962615377 PECOS PAC ID: 3375697774 Enrollment ID: I20231025000076 |
| Provider Name | Stephanie W Bostic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487433454 PECOS PAC ID: 1951758564 Enrollment ID: I20231103000366 |
| Provider Name | Ann Collier |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1487898458 PECOS PAC ID: 0042442915 Enrollment ID: I20231120003400 |
| Provider Name | Jennifer Danielle Mccraw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730804147 PECOS PAC ID: 6406204916 Enrollment ID: I20231122000472 |
| Provider Name | Robert Wayne Besinger |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1497042030 PECOS PAC ID: 7012365117 Enrollment ID: I20231130000889 |
| Provider Name | Mary Moses Hitt |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1073132775 PECOS PAC ID: 7214385327 Enrollment ID: I20231130001245 |
| Provider Name | Rachel Jannell Barksdale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558134130 PECOS PAC ID: 9032568290 Enrollment ID: I20231213001398 |
| Provider Name | Mahmoud Salhab |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154762458 PECOS PAC ID: 0446486864 Enrollment ID: I20231218001280 |
| Provider Name | Larisa Syrow |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639364037 PECOS PAC ID: 4082863022 Enrollment ID: I20231222000277 |
| Provider Name | Nandini Bakshi Batra |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801902200 PECOS PAC ID: 5991855595 Enrollment ID: I20240112002305 |
| Provider Name | Neal Prakash |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1568480838 PECOS PAC ID: 6103860184 Enrollment ID: I20240221001975 |
| Provider Name | Amanda Kellie Stegall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083483085 PECOS PAC ID: 1254775893 Enrollment ID: I20240222000314 |
| Provider Name | Melissa Lepine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275973273 PECOS PAC ID: 6103058185 Enrollment ID: I20240328001565 |
| Provider Name | Saher Suleman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1851747935 PECOS PAC ID: 6507235629 Enrollment ID: I20240402002250 |
| Provider Name | Emily Megan Mcphail |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760248926 PECOS PAC ID: 3274971155 Enrollment ID: I20240411000792 |
| Provider Name | Latangela Smith |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1790162493 PECOS PAC ID: 4587979232 Enrollment ID: I20240412000304 |
| Provider Name | Hardeep Uppal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1295295681 PECOS PAC ID: 9830539444 Enrollment ID: I20240430002322 |
Ben W. Seale, M.d., Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 971 Lakeland Dr, Suite 450, Jackson, MS 39216 Phone: 601-948-5158 Fax: 601-949-6058 | |
Central Mississippi Health Services, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3450 Highway 80 W Ste 71, Jackson, MS 39209 Phone: 601-321-2400 | |
Hni Medical Services Of Mississippi, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 969 Lakeland Dr, Jackson, MS 39216 Phone: 601-200-2000 | |
Medical Care Associates Mobile Unit Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3855 Azalea Dr, Jackson, MS 39206 Phone: 601-366-9447 | |
The Wound Care Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1850 Chadwick Dr, Jackson, MS 39204 Phone: 601-376-2561 Fax: 601-376-2570 | |
Quad Intermed Company Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5005 Old Canton Rd, Jackson, MS 39211 Phone: 601-957-3333 | |
Vanessa L. Sandifer, M.d., Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 971 Lakeland Drive, Suite 450, Jackson, MS 39216 Phone: 601-948-5158 Fax: 601-949-6058 |