Organization
INPATIENT PHYSICIAN SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHY FENDER (ADMINISTRATOR)
(601) 947-8181
Entity
Organization
Contact information
Practice address
92 RATLIFF ST, LUCEDALE, MS 39452-6537
(601) 947-8181
(601) 947-1331
Mailing address
PO BOX 1007, LUCEDALE, MS 39452-1007
(601) 947-8181
(601) 947-1331
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C00960
MEDICARE PTAN
MS
Enumeration date
08/10/2010
Last updated
12/30/2010
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