| Dr Eva Mae Henderson, MD | |
|
350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 | |
| (601) 709-5150 | |
| (601) 709-5151 |
| Full Name | Dr Eva Mae Henderson |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 350 W Woodrow Wilson Ave, Jackson, Mississippi |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033146725 | NPI | - | NPPES |
| 1692743 | Medicaid | LA | |
| 00116298 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 10119 (Mississippi) | Primary |
| Entity Name | Central Mississippi Civic Improvement Association, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134151442 PECOS PAC ID: 4183533235 Enrollment ID: O20040128000125 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Eva Mae Henderson, MD Po Box 3437, Jackson, MS 39207-3437 Ph: (601) 362-5321 | Dr Eva Mae Henderson, MD 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 Ph: (601) 709-5150 |
Lauren K Tucker, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2500 N State St, Jackson, MS 39216 Phone: 601-984-5260 Fax: 601-984-2652 | |
Kavipriya Komeswaran, Pediatrics Medicare: Medicare Enrolled Practice Location: 2500 N State St, Jackson, MS 39216 Phone: 601-815-2005 Fax: 601-815-0434 | |
Emily S Weber, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2500 N State St, Jackson, MS 39216 Phone: 601-984-4520 Fax: 601-984-5982 | |
Mr. Marcelo Eduardo Rains, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2500 North State Street, Ummc Neonatology, Jackson, MS 39216 Phone: 601-984-1000 | |
Daniel Ulises Torres Arias, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2500 N State St, Jackson, MS 39216 Phone: 888-815-2005 | |
Logan Sears Havard, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2500 N State St, Jackson, MS 39216 Phone: 601-984-1000 |