| Traditions Health | |
|
3704 Bienville Blvd Ste A3 Ocean Springs MS 39564-5710 | |
| (228) 207-0390 | |
| Not Available |
| Full Name | Traditions Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 3704 Bienville Blvd Ste A3, Ocean Springs, Mississippi |
| Authorized Official Name and Position | John Kerndl (CFO & SECRETARY) |
| Authorized Official Contact | 9797046547 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Traditions Health 6840 Carothers Pkwy Ste 550 Franklin TN 37067-8002 Ph: (979) 704-4657 | Traditions Health 3704 Bienville Blvd Ste A3 Ocean Springs MS 39564-5710 Ph: (228) 207-0390 |
| NPI Number | 1760080337 |
|---|---|
| Provider Enumeration Date | 10/15/2020 |
| Last Update Date | 06/14/2024 |
| Medicare PECOS PAC ID | 1254742745 |
|---|---|
| Medicare Enrollment ID | O20201207000080 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760080337 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | William D Mcclendon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790735652 PECOS PAC ID: 5496770208 Enrollment ID: I20051011000678 |
| Provider Name | Matthew L Emerick |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1861542482 PECOS PAC ID: 7719019108 Enrollment ID: I20100721000143 |
| Provider Name | Chanel O Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972912897 PECOS PAC ID: 1153541214 Enrollment ID: I20141013002139 |
| Provider Name | Ramona Lanea Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124484647 PECOS PAC ID: 4688962897 Enrollment ID: I20161004000579 |
| Provider Name | Anganatte Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124586086 PECOS PAC ID: 4880923861 Enrollment ID: I20190917002450 |
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