Organization
MISSISSIPPI PAIN PHYSICIANS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH STAGGS JR. MD (PRESIDENT)
(601) 482-9224
Entity
Organization
Contact information
Practice address
1001 14TH ST, MERIDIAN, MS 39301-4458
(601) 482-9224
(601) 482-9223
Mailing address
PO BOX 5377, MERIDIAN, MS 39302-5377
(800) 897-6169
(800) 897-6170
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015976
—
MS
01
—
CA7626
MEDICARE RAILROAD
MS
Enumeration date
09/07/2005
Last updated
10/15/2007
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