WEST MISSISSIPPI MEDICAL SERVICES (NPI# 1215451794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1215451794 |
Entity Type | Organization |
Organization Name | WEST MISSISSIPPI MEDICAL SERVICES |
Practice Address |
100 Mcauley Dr Vicksburg MS 39183-2825 |
Mailing Address |
607 Tiffintown Rd Vicksburg MS 39183-1503 |
Practice Telephone | 6018833532 |
Mailing Telephone | 6016368184 |
Enumeration Date | 2017-07-27 |
Last Update Date | 2017-07-27 |
Authorized Official Name | STANLEY R EASTERLING (OWNER) |
Authorized Official Telephone | 6016368184 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
10687 | MS | Allopathic & Osteopathic Physicians |
Street Address |
100 MCAULEY DR |
City | VICKSBURG |
State | MS |
Zip Code | 39183-2825 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306217823 | Tracy Curtis | Speech-Language Pathologist | 2100 Us 61, Vicksburg, MS 39183 | 2015-10-09 |
1649566894 | The Life Balance Clinic, Behavioral Health Service | Social Worker | 1107 B Openwood St., Vicksburg, MS 39183 | 2011-06-27 |
1245428788 | Melanie Joan Waldrop | Nurse Anesthetist, Certified Registered | 2100 Hwy 61n, River Region Medical Center, Vicksburg, MS 39183 | 2007-10-10 |
1871714477 | Robert Michael Coleman | Dentist | 2356 Grove Street, Vicksburg, MS 39183 | 2007-05-01 |
1942363502 | Visions Physical Therapy | Physical Therapist | 110 Holt Collier Dr, Vicksburg, MS 39183 | 2006-12-18 |
1023117991 | Janet S Fisher Dmd Pa | Dentist | 1212 Mission 66, Vicksburg, MS 39183 | 2006-09-21 |
1407878663 | Annette Bryant | Social Worker | 1107 Openwood St, Vicksburg, MS 39183 | 2006-07-24 |
1932168416 | Promise Hospital of Vicksburg Inc | Long Term Care Hospital | 2100 Highway 61 N Fl 6, Vicksburg, MS 39183 | 2006-03-22 |
1164945374 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2310 Clay St, Vicksburg, MS 39183 | 2017-07-19 |
1255777025 | Joyce Wanjugu Muruthi | Obstetrics & Gynecology | 2100 Highway 61 N, Vicksburg, MS 39183 | 2013-05-20 |
Find all providers in zip 39183 |
Taxonomy Code | 207QA0401X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Specialization | Addiction Medicine |
A family medicine physician who specializes in the diagnosis and treatment of addictions. |
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013425503 | Pathway Healthcare- Mississippi LLC | Family Medicine | 1 Medical Plaza Dr, Vicksburg, MS 39180-5187 | 2018-01-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245755990 | Pathway Healthcare- Columbus, Ms LLC | Family Medicine | 3600 Bluecutt Rd Ste 200, Columbus, MS 39705-1303 | 2017-08-03 |
1124471131 | 1st Step Medical PC | Family Medicine | 3104 Adams Farm Rd, Belden, MS 38826-7020 | 2016-07-14 |
1619981644 | Kenneth I Cronin | Family Medicine | 408 Fontaine Pl, Suite 104, Ridgeland, MS 39157-5145 | 2006-07-27 |
1619433943 | Live Oaks Addiction Professionals | Family Medicine | 5699 Getwell Rd Ste 1, Southaven, MS 38672-7312 | 2019-02-12 |
1336656628 | Pathway Healthcare- Columbus, Ms LLC | Family Medicine | 3600 Bluecutt Rd Ste 200, Columbus, MS 39705-1303 | 2018-01-08 |
1487179156 | Pathway Healthcare - Jackson, Ms, LLC | Family Medicine | 1551 E County Line Rd, Jackson, MS 39211-1801 | 2017-08-03 |
1376929901 | Sw Mediacal Inc | Family Medicine | 2561 Pass Rd, Suite D, Biloxi, MS 39531-2125 | 2015-08-05 |
1669697801 | William Lelon Aron Jr. | Family Medicine | 1551 E County Line Rd, Jackson, MS 39211-1801 | 2007-04-14 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.