| Dr Mark Runnels, | |
|
1421 N State St, Ste 403, Jackson, MS 39202-1658 | |
| (601) 353-9900 | |
| (601) 353-3654 |
| Full Name | Dr Mark Runnels |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 15 Years |
| Location | 1421 N State St, Jackson, 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 |
|---|---|---|---|
| 1144532391 | NPI | - | NPPES |
| 23772 | Other | MS | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | T-2356 (Mississippi) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Mississippi Homecare Of Jackson | Jackson, MS | Home health agency |
| Mississippi Baptist Medical Center | Jackson, MS | Hospital |
| St Dominic-jackson Memorial Hospital | Jackson, MS | Hospital |
| Baptist Medical Center-leake | Carthage, MS | Hospital |
| Merit Health River Oaks | Flowood, MS | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mississippi Urology Clinic Pllc | 6406830942 | 12 |
| Entity Name | Mississippi Urology Clinic Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902837313 PECOS PAC ID: 6406830942 Enrollment ID: O20040614001229 |
| Entity Name | Mississippi Urology Outpatient Surgery Center Llc |
|---|---|
| Entity Type | Part B Supplier - Ambulatory Surgical Center |
| Entity Identifiers | NPI Number: 1548655053 PECOS PAC ID: 4284936790 Enrollment ID: O20151230000237 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Mark Runnels, 501 Marshall St, Ste 301, Jackson, MS 39202-1687 Ph: (601) 353-9900 | Dr Mark Runnels, 1421 N State St, Ste 403, Jackson, MS 39202-1658 Ph: (601) 353-9900 |
Robert Tramel, Urology Medicare: Medicare Enrolled Practice Location: 2500 N State St, Jackson, MS 39216 Phone: 769-798-4747 | |
Dr. Michael Tyler Wood, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 2500 N State St, Jackson, MS 39216 Phone: 601-984-5101 | |
Dr. Kieran Hynes, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 501 Marshall St Ste 301, Jackson, MS 39202 Phone: 601-353-9900 | |
Ronald D Davis, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 971 Lakeland Dr, Suite 360, Jackson, MS 39216 Phone: 601-200-4370 Fax: 601-200-4375 | |
Joe R. Ross, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 1421 N State St, Suite 403, Jackson, MS 39202 Phone: 601-353-9900 Fax: 601-353-3654 | |
Deep Asit Gandhi, MD Urology Medicare: Medicare Enrolled Practice Location: 2500 N State St, Jackson, MS 39216 Phone: 601-984-1000 |