Edward Daniel Henderson Jr. (NPI# 1346222890, PAC ID# 6103723713) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
Nation Provider ID (NPI) | 1346222890 |
PAC ID by PECOS | 6103723713 |
Professional Enrollment ID | I20040120000522 |
Full Name | Edward Daniel Henderson Jr. |
Organization Legal Name | LAIRD HOSPITAL, INC. |
Address |
9097 Collinsville Rd Collinsville MS 39325-9779 |
Phone Number | 6016268874 |
Gender | M |
Credential | MD |
Medical School | UNIVERSITY OF MIAMI SCHOOL OF MEDICINE |
Graduation Year | 1993 |
Primary Specialty | FAMILY MEDICINE |
Group Practice PAC ID | 7214991769 |
Number of Group Practice Members | 42 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
251322 | LAIRD HOSPITAL INC |
250069 | RUSH FOUNDATION HOSPITAL |
250104 | ANDERSON REGIONAL MEDICAL CTR |
250152 | MISSISSIPPI METHODIST REHAB CTR |
Address | Phone | Organization |
---|---|---|
9097 Collinsville Rd, Collinsville, MS 39325-9779 | 6016268874 | LAIRD HOSPITAL, INC. |
Organization Legal Name | LAIRD HOSPITAL, INC. |
Physicians | 31 |
Name | Specialty | Organization | Address |
---|---|---|---|
Hunter J Harrison | Family Medicine | Laird Hospital, Inc. | 1500 Hwy 19 N, Meridian, MS 39307-5335 |
Alisha Miller | Nurse Practitioner | Laird Hospital, Inc. | 1106 Central Dr, Philadelphia, MS 39350-8972 |
Michelle L Roark | Certified Nurse Midwife (cnm) | Laird Hospital, Inc. | 1221 24th Ave, Meridian, MS 39301-3926 |
Cynthia B. Massey | Nurse Practitioner | Laird Hospital, Inc. | 14884 Hwy 15, Decatur, MS 39327-9697 |
Frederick T Duggan | Pulmonary Disease | Laird Hospital, Inc. | 25117 Hwy 15, Union, MS 39365-9088 |
Angela K Skinner | Nurse Practitioner | Laird Hospital, Inc. | 9097 Collinsville Rd, Collinsville, MS 39325-9779 |
Mary E Spreafico | Nurse Practitioner | Laird Hospital, Inc. | 24345 Hwy 15, Union, MS 39365-8575 |
Patrick H Eakes | Internal Medicine | Laird Hospital, Inc. | 1106 Central Dr, Philadelphia, MS 39350-8972 |
Walter L Willis | Emergency Medicine | Laird Hospital, Inc. | 25117 Hwy 15, Union, MS 39365-9088 |
Krista L Boyette | Family Medicine | Laird Hospital, Inc. | 1106 Central Dr, Philadelphia, MS 39350-8972 |
Street Address |
9097 COLLINSVILLE RD |
City | COLLINSVILLE |
State | MS |
Zip | 39325-9779 |
Name | Specialty | Organization | Address |
---|---|---|---|
Angela K Skinner | Nurse Practitioner | Laird Hospital, Inc. | 9097 Collinsville Rd, Collinsville, MS 39325-9779 |
Lesley Robinson Vincent | Nurse Practitioner | Laird Hospital, Inc. | 9097 Collinsville Rd, Collinsville, MS 39325-9779 |
Shannon R Mott | Nurse Practitioner | Laird Hospital, Inc. | 9097 Collinsville Rd, Collinsville, MS 39325-9779 |
Name | Specialty | Organization | Address |
---|---|---|---|
Danny T Fritts | Physical Therapy | 9099 A Collinsville Rd, Collinsville, MS 39325-9779 |
City | COLLINSVILLE |
Zip Code | 39325 |
Specialty | FAMILY MEDICINE |
City + Specialty | COLLINSVILLE + FAMILY MEDICINE |
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Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.