Individual
PAUL W PIERCE IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2100 HIGHWAY 61 N, VICKSBURG, MS 39183-8211
(601) 883-5000
Mailing address
4211 BERLIN DR, JACKSON, MS 39211-6016
(601) 613-9597
(601) 984-2631
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
17287
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060000818
—
MS
05
—
06581329
—
MS
05
—
1028835
—
LA
01
—
731-04204
BCBS
AL
01
—
P00215144
RAILROAD MEDICARE
MS
Enumeration date
08/01/2006
Last updated
09/14/2020
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