| Michael R Wimberly Ii, PT,MPT | |
|
107 Front St Ste 230, Vidalia, LA 71373-2836 | |
| (318) 336-2224 | |
| (318) 336-6068 |
| Full Name | Michael R Wimberly Ii |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist In Private Practice |
| Experience | 24 Years |
| Location | 107 Front St Ste 230, Vidalia, Louisiana |
| 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 |
|---|---|---|---|
| 1700937950 | NPI | - | NPPES |
| 04220001 | Medicaid | MS | |
| 2318781 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT04879 (Louisiana) | Primary |
| 225100000X | Physical Therapist | PT3657 (Mississippi) | Secondary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| J H Fairbanks, Md Pllc | 2062504798 | 2 |
| Provider Name | J H Fairbanks, Md Pllc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1336209550 PECOS PAC ID: 2062504798 Enrollment ID: O20070824000710 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael R Wimberly Ii, PT,MPT 901 Lindberg Ave, Natchez, MS 39120-4884 Ph: (601) 304-4161 | Michael R Wimberly Ii, PT,MPT 107 Front St Ste 230, Vidalia, LA 71373-2836 Ph: (318) 336-2224 |
Mrs. Lacey Ozburn, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 4616 Highway 84 W, Vidalia, LA 71373 Phone: 318-336-5400 Fax: 318-336-8621 | |
Erin Fournet Woodruff, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 402 Holly Street, Vidalia, LA 71373 Phone: 318-336-6500 | |
Miss Jessica Marling Clayton, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 4616 Highway 84 W, Vidalia, LA 71373 Phone: 318-336-5400 Fax: 318-336-8621 |