| Catherine Petzinger Deshazo, DO | |
|
5480 Goodman Rd, Olive Branch, MS 38654-7902 | |
| (662) 893-9815 | |
| (662) 893-9888 |
| Full Name | Catherine Petzinger Deshazo |
|---|---|
| Gender | Female |
| Speciality | General Surgery |
| Experience | 11 Years |
| Location | 5480 Goodman Rd, Olive Branch, Mississippi |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962822692 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 26737 (Mississippi) | Primary |
| 208600000X | Surgery | 5101020893 (Michigan) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Methodist Healthcare - Olive Branch Hospital | Olive branch, MS | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Spg Ii Llc | 7012177132 | 5 |
| Entity Name | Bolivar Physician Practices Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063659530 PECOS PAC ID: 6305995895 Enrollment ID: O20090512000274 |
| Entity Name | Spg Ii Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1255602587 PECOS PAC ID: 7012177132 Enrollment ID: O20120515000546 |
| Mailing Address | Practice Location Address |
|---|---|
| Catherine Petzinger Deshazo, DO 1211 Union Ave Ste 330, Memphis, TN 38104-6655 Ph: (901) 478-0966 | Catherine Petzinger Deshazo, DO 5480 Goodman Rd, Olive Branch, MS 38654-7902 Ph: (662) 893-9815 |
Dr. Michael E. Foster, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 5036 Goodman Rd, Suite #116, Olive Branch, MS 38654 Phone: 662-420-7061 Fax: 662-420-7583 | |
Dr. Thomas Bass Beasley, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 5480 Goodman Rd Ste 3, Olive Branch, MS 38654 Phone: 662-893-9815 Fax: 662-893-9888 |