| Jefferson Neurology Clinic, LLC | |
|
319 S 13th Ave Laurel MS 39440-4342 | |
| (601) 649-2863 | |
| Not Available |
| Full Name | Jefferson Neurology Clinic, LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 319 S 13th Ave, Laurel, Mississippi |
| Authorized Official Name and Position | Aremmia Tanious (OWNER) |
| Authorized Official Contact | 6014262140 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jefferson Neurology Clinic, LLC 319 S 13th Ave Laurel MS 39440-4342 | Jefferson Neurology Clinic, LLC 319 S 13th Ave Laurel MS 39440-4342 Ph: (601) 649-2863 |
| NPI Number | 1518486943 |
|---|---|
| Provider Enumeration Date | 09/18/2017 |
| Last Update Date | 01/27/2024 |
| Certification Date | 01/27/2024 |
| Medicare PECOS PAC ID | 5395006977 |
|---|---|
| Medicare Enrollment ID | O20180222000090 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518486943 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| Provider Name | Hannah E Mccallum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295884617 PECOS PAC ID: 1355324336 Enrollment ID: I20040610000945 |
| Provider Name | Aremmia Tanious |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1184638033 PECOS PAC ID: 1951373588 Enrollment ID: I20040812000701 |
| Provider Name | Justin L Cole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588053052 PECOS PAC ID: 9436474061 Enrollment ID: I20150202001935 |
| Provider Name | Laura R Boleware |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437540325 PECOS PAC ID: 6204143464 Enrollment ID: I20150921001238 |
| Provider Name | Brittany L Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073964946 PECOS PAC ID: 4789978727 Enrollment ID: I20160813000029 |
| Provider Name | Tiffany L Hilbun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013396837 PECOS PAC ID: 8729366810 Enrollment ID: I20161024002687 |
| Provider Name | Brittany Poole Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730605593 PECOS PAC ID: 4587939335 Enrollment ID: I20171004003778 |
| Provider Name | Regan M Roney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730675612 PECOS PAC ID: 4183974108 Enrollment ID: I20180912000668 |
| Provider Name | Courtney J Sims |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881227759 PECOS PAC ID: 8729419692 Enrollment ID: I20200508000405 |
| Provider Name | Illisia Marie Johnston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003486556 PECOS PAC ID: 2062800691 Enrollment ID: I20211101000338 |
| Provider Name | Lakin Sellers Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215685664 PECOS PAC ID: 4082001912 Enrollment ID: I20220425000946 |
| Provider Name | Anna Hendry Walters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174472609 PECOS PAC ID: 9436639408 Enrollment ID: I20260218000818 |
| Provider Name | Aundrea Sheree Lovelace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477390797 PECOS PAC ID: 5092297713 Enrollment ID: I20260303002585 |
South Central Urgent Care and Industrial Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1515 Jefferson St, Laurel, MS 39440 Phone: 601-426-3421 Fax: 601-426-2493 |
The Fhc Foundation for Health Care Disparities, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 117 S 11th Ave, Laurel, MS 39440 Phone: 601-425-3033 |
SC Wound Care & Hyperbaric Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1220 Jefferson St, Laurel, MS 39440 Phone: 601-426-4739 Fax: 601-426-4739 |
Family Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 117 S 11th Ave, Laurel, MS 39440 Phone: 601-425-3033 Fax: 601-428-6561 |
Family Health Center Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 117 S 11th Ave, Laurel, MS 39440 Phone: 601-425-3033 Fax: 601-422-0431 |
Jefferson Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1203 Jefferson St, Laurel, MS 39440 Phone: 601-649-2863 Fax: 601-649-9479 |