Emmanuel Mendoza, PA-C is a
Physician Assistant based in Vancleave, Mississippi. Emmanuel Mendoza is licensed to practice in Mississippi (license number PA00846) and his current practice location is
6300 E Lake Blvd Ste 201, Vancleave, Mississippi. He can be reached at his office (for appointments etc.) via phone at
(228) 230-2663.
NPI number for Emmanuel Mendoza is 1225856602 and his current mailing address is 6300 E Lake Blvd Ste 301, Vancleave, Mississippi. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1225856602.
Provider's Profile
Full Name | Emmanuel Mendoza |
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Gender | Male |
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Speciality | Physician Assistant |
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Location | 6300 E Lake Blvd Ste 201, Vancleave, Mississippi |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1225856602
- Provider Enumeration Date: 10/02/2024
- Last Update Date: 02/25/2025
Medical Identifiers
Medical identifiers for Emmanuel Mendoza such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1225856602 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | PA00846 (Mississippi) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Emmanuel Mendoza is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Emmanuel Mendoza, PA-C 6300 E Lake Blvd Ste 301, Vancleave, MS 39565-6771 Ph: (228) 230-2663 | Emmanuel Mendoza, PA-C 6300 E Lake Blvd Ste 201, Vancleave, MS 39565-6771 Ph: (228) 230-2663 |
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