| Dr Justin Blake Daniels, MD | |
|
103 Brighton Ln, Apt/suite, Ridgeland, MS 39157-8775 | |
| (601) 421-9943 | |
| Not Available |
| Full Name | Dr Justin Blake Daniels |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Experience | 16 Years |
| Location | 103 Brighton Ln, Ridgeland, Mississippi |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013228329 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | T-2302 (Mississippi) | Primary |
| 207P00000X | Emergency Medicine | 21838 (Mississippi) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| South Baldwin Regional Medical Center | Foley, AL | Hospital |
| Merit Health River Oaks | Flowood, MS | Hospital |
| Merit Health River Region | Vicksburg, MS | Hospital |
| Andalusia Health | Andalusia, AL | Hospital |
| Merit Health Central | Jackson, MS | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Ies Alabama Pllc | 5395105183 | 24 |
| Jackson Hb Medical Services Llc | 6103273131 | 51 |
| Entity Name | Ies Alabama Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053027276 PECOS PAC ID: 5395105183 Enrollment ID: O20230712000361 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Justin Blake Daniels, MD 103 Brighton Ln, Apt/suite, Ridgeland, MS 39157-8775 Ph: (601) 421-9943 | Dr Justin Blake Daniels, MD 103 Brighton Ln, Apt/suite, Ridgeland, MS 39157-8775 Ph: (601) 421-9943 |
Dr. Nathan Philip Mcintosh, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 212 Draperton Ct, Ridgeland, MS 39157 Phone: 769-300-9040 | |
Dr. David L. Merideth, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 407b W Parkway Pl, Ridgeland, MS 39157 Phone: 601-856-7799 Fax: 601-856-6112 | |
Julian F Rose, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 403 Towne Center Blvd, Ste. 101a, Ridgeland, MS 39157 Phone: 601-982-7111 Fax: 601-981-2524 |