| Dr Michael Tristan Peavey Sr, MD | |
|
1311 Aston Ave, Mccomb, MS 39648-2825 | |
| (601) 684-2481 | |
| (601) 684-2488 |
| Full Name | Dr Michael Tristan Peavey Sr |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 25 Years |
| Location | 1311 Aston Ave, Mccomb, 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 |
|---|---|---|---|
| 1932295995 | NPI | - | NPPES |
| 00122130 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 14452 (Mississippi) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Southwest Ms Regional Medical Center | Mccomb, MS | Hospital |
| King's Daughters Medical Center-brookhaven | Brookhaven, MS | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Southwest Mississippi Regional Medical Center | 5193633907 | 83 |
| Entity Name | Southwest Mississippi Regional Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1982174488 PECOS PAC ID: 5193633907 Enrollment ID: O20080512000004 |
| Entity Name | Brookhaven Surgery Clinic P.a. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760578736 PECOS PAC ID: 7618043597 Enrollment ID: O20080828000311 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Michael Tristan Peavey Sr, MD Po Box 490, Mccomb, MS 39649-0490 Ph: (601) 250-4366 | Dr Michael Tristan Peavey Sr, MD 1311 Aston Ave, Mccomb, MS 39648-2825 Ph: (601) 684-2481 |
William N Dixon, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1311 Aston Ave, Mccomb, MS 39648 Phone: 601-684-2481 Fax: 601-684-2488 | |
Steven C Williams, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 1311 Aston Ave, Mccomb, MS 39648 Phone: 601-684-2481 Fax: 601-684-2488 |