| Jose P Fernandez Jr, MD | |
|
1 Lincoln Pkwy Ste 302, Hattiesburg, MS 39402-3261 | |
| (601) 268-5620 | |
| (601) 268-5851 |
| Full Name | Jose P Fernandez Jr |
|---|---|
| Gender | Male |
| Speciality | Neurology |
| Experience | 34 Years |
| Location | 1 Lincoln Pkwy Ste 302, Hattiesburg, 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 |
|---|---|---|---|
| 1144230491 | NPI | - | NPPES |
| 1484091 | Medicaid | LA | |
| 1559337 | Other | MS | AMERICAN ADMIN GROUP |
| 00123815 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 15140 (Mississippi) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Hattiesburg Clinic Pa | 5193706794 | 492 |
| Entity Name | Hattiesburg Clinic Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740213446 PECOS PAC ID: 5193706794 Enrollment ID: O20040528000685 |
| Entity Name | Forrest County General Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295837631 PECOS PAC ID: 1052397767 Enrollment ID: O20040624001351 |
| Entity Name | Fgh Physician Billing |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053469700 PECOS PAC ID: 1850344946 Enrollment ID: O20050301000617 |
| Mailing Address | Practice Location Address |
|---|---|
| Jose P Fernandez Jr, MD 415 S 28th Ave, Hattiesburg, MS 39401-7246 Ph: (601) 268-5620 | Jose P Fernandez Jr, MD 1 Lincoln Pkwy Ste 302, Hattiesburg, MS 39402-3261 Ph: (601) 268-5620 |
Dr. Raymond L Struck, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 103 S 19th Ave, Hattiesburg, MS 39401 Phone: 601-544-4641 Fax: 601-582-1607 | |
Joshua A Maksi, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 415 S 28th Ave, Hattiesburg, MS 39401 Phone: 601-268-5620 Fax: 601-268-5851 | |
Bertha J Blanchard, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 105 Asbury Cir, Suite A, Hattiesburg, MS 39402 Phone: 601-268-5222 Fax: 601-296-3508 | |
Roopsi Bassi, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 2117 Broadway Drive, Hattiesburg, MS 39402 Phone: 601-288-8050 Fax: 601-288-8058 | |
Dr. Thomas A Miller, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 2117 Broadway Drive, Hattiesburg, MS 39402 Phone: 601-288-8050 Fax: 601-288-8058 | |
Geoffrey B Hartwig, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 415 S 28th Ave, Hattiesburg, MS 39401 Phone: 601-268-5620 Fax: 601-268-5851 |