Individual
DR. VERNON A CHASE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DR
Contact information
Practice address
176 S MAIN ST, PONTOTOC, MS 38863-3311
(662) 488-7640
(662) 488-7675
Mailing address
1309 CARROLLVILLE AVE, BALDWYN, MS 38824-1112
(601) 365-7721
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
05771
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12626
—
MS
Enumeration date
03/02/2007
Last updated
07/08/2007
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