Organization
PIONEER HEALTH SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH S MCNULTY II CRT (PRESIDENT)
(601) 849-4112
Entity
Organization
Contact information
Practice address
301 8TH AVE SW, MAGEE, MS 39111-3967
(601) 849-6440
(601) 849-7557
Mailing address
PO BOX 1100, MAGEE, MS 39111-1100
(601) 849-6440
(601) 849-7557
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MS
Enumeration date
07/09/2006
Last updated
06/02/2008
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