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Individual

DR. JOHN THOMAS PESSONEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5912 OLD MOBILE HIGHWAY, SUITE 1, PASCAGOULA, MS 39581
(228) 471-1000
(228) 471-1039
Mailing address
5912 OLD MOBILE HWY, SUITE 1, PASCAGOULA, MS 39581-4520
(228) 471-1000
(228) 471-1039

Taxonomy

Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
2003000629
MO
2083X0100X
Occupational Medicine Physician
Primary
20863
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
204642102
MEDICAID
MO
05
243419306
MO
Enumeration date
09/11/2006
Last updated
04/29/2010
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