| Kory Blackwell, | |
|
5192 Old Highway 11 Ste 2, Hattiesburg, MS 39402-6222 | |
| (601) 268-0929 | |
| (601) 261-0508 |
| Full Name | Kory Blackwell |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 11 Years |
| Location | 5192 Old Highway 11 Ste 2, 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 |
|---|---|---|---|
| 1255751525 | NPI | - | NPPES |
| 08076764 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 24444 (Mississippi) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Forrest General Home Care | Hattiesburg, MS | Home health agency |
| 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 |
| Mailing Address | Practice Location Address |
|---|---|
| Kory Blackwell, 415 South 28th Avenue, Hattiesburg, MS 39401 Ph: (601) 579-5463 | Kory Blackwell, 5192 Old Highway 11 Ste 2, Hattiesburg, MS 39402-6222 Ph: (601) 268-0929 |
Katherine O'neal Royals, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 15 Orleans Dr, Hattiesburg, MS 39402 Phone: 601-579-5050 Fax: 601-579-5240 | |
Nabih Alsheikh, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 7100 U S Highway 98 Ste 240, Hattiesburg, MS 39402 Phone: 601-450-8822 Fax: 601-450-8821 | |
Glenn A Campbell, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 4209 Lincoln Road, Hattiesburg, MS 39402 Phone: 601-579-5400 Fax: 601-261-3521 | |
Dr. Cierra Celeste Green, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 66 Old Airport Rd, Hattiesburg, MS 39401 Phone: 601-544-7500 Fax: 601-544-7524 | |
Dr. Wayne A Hughes, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 110 Millsaps Dr, Hattiesburg, MS 39402 Phone: 601-261-5710 Fax: 601-268-5058 | |
John Lloyd Martin, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 7148 U S Highway 98 Ste 101, Hattiesburg, MS 39402 Phone: 601-261-1500 Fax: 601-579-5240 | |
Helen Rachael Gandy Hudson, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 15 Orleans Dr, Hattiesburg, MS 39402 Phone: 601-579-5050 Fax: 601-579-5240 |