Organization
EZE PS FAMILY MEDICAL CLINIC
Active
Other names
EZE P'S MEDICAL SUPPLY
Organization subpart
No
Provider details
NPI number
Authorized official
PLACID M EZE MD (PHYSICIAN OWNER)
(662) 323-4400
Entity
Organization
Contact information
Practice address
900 STARK ROAD, STARKVILLE, MS 39759
(662) 323-4400
(662) 323-4409
Mailing address
900 STARK ROAD, STARKVILLE, MS 39759
(662) 323-4400
(662) 323-4409
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09728046
—
MS
05
—
1776696
—
LA
01
—
DB6431
RAILROAD MEDICARE
—
Enumeration date
04/17/2007
Last updated
05/23/2018
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