Organization
SOUTH MISSISSIPPI EMERGENCY PHYSICIANS,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN NELSON M.D. (PRESIDENT)
(601) 288-2010
Entity
Organization
Contact information
Practice address
4891 HIGHWAY 589, SUMRALL, MS 39482-4453
(601) 758-4606
(601) 758-4615
Mailing address
PO BOX 635614, CINCINNATI, OH 45263-0001
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09016106
—
MS
Enumeration date
07/25/2007
Last updated
01/22/2021
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