DR. ANTHONY BEDEAR PETRO (NPI# 1487769154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487769154 |
| Entity Type | Individual |
| Full Name | DR. ANTHONY BEDEAR PETRO |
| Credential | M.D. |
| Practice Address |
501 Marshall St Suite 500 Jackson MS 39202-1651 |
| Practice Telephone | 6019481411 |
| Practice Fax Number | 6019480090 |
| Mailing Telephone | 6019481411 |
| Mailing Fax Number | 6019480090 |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2009-11-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 05828 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 000017867 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821160557 | Anthony J. Petro | Dentist | 6659 Pearl Rd, Suite 403, Parma Heights, OH 44130-3821 | 2006-11-15 |
| Street Address |
501 MARSHALL ST SUITE 500 |
| City | JACKSON |
| State | MS |
| Zip Code | 39202-1651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932176641 | Sabra Sullivan | Dermatology | 501 Marshall St, Suite 606, Jackson, MS 39202-1651 | 2006-03-01 |
| 1598328684 | Caroline Douglass Peeples | Registered Nurse | 501 Marshall St, Jackson, MS 39202-1651 | 2019-04-15 |
| 1548655053 | Mississippi Urology Outpatient Surgery Center, LLC | Clinic/Center | 501 Marshall St, Suite 201, Jackson, MS 39202-1651 | 2015-04-01 |
| 1639586076 | Baptist Heart | Internal Medicine | 501 Marshall St, Suite 104, Jackson, MS 39202-1651 | 2014-07-17 |
| 1568709574 | Medical Foundation of Central Ms | Surgery | 501 Marshall St, Suite 500, Jackson, MS 39202-1651 | 2013-01-10 |
| 1417291451 | Urogyn Diagnostics LLC | Obstetrics & Gynecology | 501 Marshall St, Suite 600, Jackson, MS 39202-1651 | 2012-11-15 |
| 1548513617 | Southeast Urogyn LLC | Obstetrics & Gynecology | 501 Marshall St, Suite 600, Jackson, MS 39202-1651 | 2012-10-26 |
| 1477825800 | The Medical Foundation of Central Mississippi | Clinic/Center | 501 Marshall St, Suite 100, Jackson, MS 39202-1651 | 2012-02-01 |
| 1265712145 | Laurie Selman Nimon | Nurse Practitioner | 501 Marshall St, Suite 600, Jackson, MS 39202-1651 | 2011-08-23 |
| 1992034771 | Southeast Urogynecology Pa | Urology | 501 Marshall St, Suite 607-a, Jackson, MS 39202-1651 | 2009-12-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982234183 | Eva Mackenzie Carmody | Physician Assistant | 1190 N State St Suite 502, Jackson, MS 39202 | 2020-01-16 |
| 1750868691 | Katherine Walters | Nurse Practitioner | 501 Marshall St., Suite 400, Jackson, MS 39202 | 2018-07-24 |
| 1932638749 | Tylan Lee | Social Worker | 860 East River Place Suite 100, Jackson, MS 39202 | 2017-06-06 |
| 1417314725 | Euna Jyles | Counselor | 860 E River Pl, Jackson, MS 39202 | 2016-01-19 |
| 1255712048 | Edward Jonathan Breight | Specialist/Technologist | 1325 East Fortication Street, Jackson, MS 39202 | 2015-06-17 |
| 1881037703 | Kara Spinks Logan | Surgery | 1190 N State St Ste 502, Jackson, MS 39202 | 2013-04-10 |
| 1477876530 | Mick Inc. | Technician | 334 Josanna Street, Suite #209, Jackson, MS 39202 | 2010-03-03 |
| 1073724910 | Paul Frederic Dare | Anesthesiology | 1151 North State St., Suite 311, Jackson Anesthesia Associates, Jackson, MS 39202 | 2007-05-24 |
| 1225247703 | Lynn Kincannon Holland | Counselor | 911 Manship Street, Unit A, Jackson, MS 39202 | 2007-05-22 |
| 1457568149 | Incare Inc | Pulmonary Function Technologist | 1151 North State St, Suite 406, Jackson, MS 39202 | 2007-05-16 |
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| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851731103 | Zachary James Virgin | Surgery | 300 W Washington Ave Ste 300, Jackson, MI 49201-2160 | 2013-07-01 |
| 1407290372 | Derek S. Palmer | Surgery | 120 District Blvd Apt 433, Jackson, MS 39211-6389 | 2013-04-23 |
| 1881037703 | Kara Spinks Logan | Surgery | 1190 N State St Ste 502, Jackson, MS 39202 | 2013-04-10 |
| 1639419997 | Fred Silvestri Md, LLC | Surgery | 4 Long Bay Rd, Jackson, NJ 08527-2662 | 2013-02-25 |
| 1528356482 | James P. Spell | Surgery | 21 Lamplighter Rd., Jackson, MS 39208 | 2011-07-13 |
| 1629371018 | Richard L Yelverton Md Pa | Surgery | 1040 River Oaks Dr Ste 102, Jackson, MS 39232-9539 | 2010-12-07 |
| 1619125952 | Otha Edward Williams Jr. | Surgery | 1736 Lake Trace Dr, Jackson, MS 39211-3353 | 2008-08-28 |
| 1770604803 | Rajesh Kuruba | Surgery | 1500 E Woodrow Wilson Ave., Jackson, MS 39216-5199 | 2007-04-03 |
| 1679692396 | Reginald Willis Martin | Surgery | 971 Lakeland Dr Ste 211, Jackson, MS 39216-4607 | 2007-03-28 |
| 1295878783 | P George Poore | Surgery | 555 East Broadway Ste 212, Jackson, WY 83001-4777 | 2007-02-14 |
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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.