Mr Jamarcus Keon Captville Sr, is a
Psychologist - Health Service based in Lucedale, Mississippi. Mr Jamarcus Keon Captville Sr is licensed to practice in * (Not Available) (license number ) and his current practice location is
433 Winter St, Lucedale, Mississippi. He can be reached at his office (for appointments etc.) via phone at
(225) 877-8566.
NPI number for Mr Jamarcus Keon Captville Sr is 1760293476 and his current mailing address is 950 Monterrey Blvd, Baton Rouge, Louisiana. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1760293476.
Healthcare Provider's Profile
| Full Name | Mr Jamarcus Keon Captville Sr |
|---|
| Gender | Male |
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| Speciality | Psychologist - Health Service |
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| Location | 433 Winter St, Lucedale, Mississippi |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1760293476
- Provider Enumeration Date: 01/14/2025
- Last Update Date: 01/14/2025
Medical Identifiers
Medical identifiers for Mr Jamarcus Keon Captville Sr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1760293476 | NPI | - | NPPES |
| 1386450104 | Medicaid | MS | |
| 1386450104 | Medicaid | LA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103TH0100X | Psychologist - Health Service | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Jamarcus Keon Captville Sr is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Jamarcus Keon Captville Sr,
950 Monterrey Blvd,
Baton Rouge, LA 70815-1155
Ph: (225) 877-8566 | Mr Jamarcus Keon Captville Sr,
433 Winter St,
Lucedale, MS 39452-6607
Ph: (225) 877-8566 |
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