Wiggins Primary Care | |
975 Hall St Wiggins MS 39577-2107 | |
(601) 528-9119 | |
(601) 528-9193 |
Full Name | Wiggins Primary Care |
---|---|
Speciality | Clinic/Center |
Location | 975 Hall St, Wiggins, Mississippi |
Authorized Official Name and Position | Kathy Fender (ADMINISTRATOR) |
Authorized Official Contact | 6019478181 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Wiggins Primary Care Po Box 1007 Lucedale MS 39452-1007 Ph: (601) 528-9119 | Wiggins Primary Care 975 Hall St Wiggins MS 39577-2107 Ph: (601) 528-9119 |
NPI Number | 1740293257 |
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Provider Enumeration Date | 08/14/2006 |
Last Update Date | 11/07/2019 |
Medicare PECOS PAC ID | 5890737019 |
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Medicare Enrollment ID | O20050527000428 |
Identifier | Type | State | Issuer |
---|---|---|---|
1740293257 | NPI | - | NPPES |
C03308 | Other | MS | MEDICARE CAHABA |
00488801 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (Mississippi) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Provider Name | Glynnis D Randall |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1346355583 PECOS PAC ID: 4183605967 Enrollment ID: I20040527000304 |
Provider Name | Donald R Doran |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1518906734 PECOS PAC ID: 9638141674 Enrollment ID: I20040810000721 |
Provider Name | Deepinder S Burn |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1639182124 PECOS PAC ID: 0143274316 Enrollment ID: I20050310000306 |
Provider Name | Heather H Hager |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1740347483 PECOS PAC ID: 4789780735 Enrollment ID: I20070508000268 |
Provider Name | Deborah Ann Hyatt |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1063428449 PECOS PAC ID: 6709936172 Enrollment ID: I20120821001025 |
Provider Name | Michelle Lorraine Mcqueen |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922381466 PECOS PAC ID: 8426294695 Enrollment ID: I20130412000138 |
Provider Name | Christian C Langley |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750798344 PECOS PAC ID: 7012135429 Enrollment ID: I20140827000716 |
Provider Name | Courtney Lauren Burns |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1346642428 PECOS PAC ID: 6305162462 Enrollment ID: I20150309000102 |
Provider Name | Kelley Elizabeth Debar |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1942609664 PECOS PAC ID: 2961729777 Enrollment ID: I20150316000847 |
Provider Name | Crystal Renee Stafford |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1851816797 PECOS PAC ID: 6800154113 Enrollment ID: I20171214001190 |
Provider Name | Tristan Green Diaz |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487127031 PECOS PAC ID: 8729327507 Enrollment ID: I20190222002500 |
Provider Name | Hieu Pham Gia Nguyen |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1952854978 PECOS PAC ID: 8820338973 Enrollment ID: I20190327001967 |
Provider Name | Holly M White |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730799578 PECOS PAC ID: 7911325477 Enrollment ID: I20200915002023 |
Provider Name | Tyler Owen Howell |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1619464948 PECOS PAC ID: 7113276023 Enrollment ID: I20201130000798 |
Provider Name | Kayla Marie Cooley |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1003404732 PECOS PAC ID: 4183031966 Enrollment ID: I20210323000256 |
Provider Name | Cody Lynn Davis |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1427554823 PECOS PAC ID: 6103171749 Enrollment ID: I20210608003615 |
Provider Name | Jessica Marie Smith |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1700550233 PECOS PAC ID: 0941607303 Enrollment ID: I20210928000981 |
Provider Name | Jason Keith Ely |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1104595396 PECOS PAC ID: 4082002548 Enrollment ID: I20211102002819 |
Provider Name | Kristin Jordan |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225622384 PECOS PAC ID: 3870901291 Enrollment ID: I20220216000937 |
Provider Name | Alaina Brooke Huff-brown |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417681446 PECOS PAC ID: 3779968698 Enrollment ID: I20220913003711 |
Provider Name | Benjamin Eugene Giuffria |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1598385767 PECOS PAC ID: 7214396043 Enrollment ID: I20230711002429 |
Provider Name | Melanie Linton Hughes |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275397507 PECOS PAC ID: 9032554621 Enrollment ID: I20240305003902 |
Provider Name | Taylor Lynn Hultz |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1952166753 PECOS PAC ID: 6709223001 Enrollment ID: I20240322000186 |
Memorial Stone County Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1440 Central Ave E, Wiggins, MS 39577 Phone: 601-928-6600 Fax: 601-928-6610 | |
Wiggins Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 805 Hall St, Wiggins, MS 39577 Phone: 601-928-4412 Fax: 601-928-4792 | |
Coastal Family Health Center, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1407 Central Ave E, Wiggins, MS 39577 Phone: 601-385-0077 Fax: 601-385-0078 | |
Stone County Family Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1434 Central Ave E, Wiggins, MS 39577 Phone: 601-928-6600 Fax: 601-928-6658 | |
Poplarville Family Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1434 Central Ave E, Wiggins, MS 39577 Phone: 601-928-6600 Fax: 601-928-6658 |