| Miss-lou Gi PLLC | |
|
136 Jeff Davis Blvd Ste B Natchez MS 39120 | |
| (601) 492-2224 | |
| (601) 492-2231 |
| Full Name | Miss-lou Gi PLLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 136 Jeff Davis Blvd, Natchez, Mississippi |
| Authorized Official Name and Position | Kellen T Jex (OWNER) |
| Authorized Official Contact | 6015974449 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Miss-lou Gi PLLC 136 Jeff Davis Blvd Ste B Natchez MS 39120 Ph: (601) 492-2224 | Miss-lou Gi PLLC 136 Jeff Davis Blvd Ste B Natchez MS 39120 Ph: (601) 492-2224 |
| NPI Number | 1295492437 |
|---|---|
| Provider Enumeration Date | 11/23/2021 |
| Last Update Date | 03/31/2022 |
| Certification Date | 03/31/2022 |
| Medicare PECOS PAC ID | 3678963618 |
|---|---|
| Medicare Enrollment ID | O20211206001030 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295492437 | NPI | - | NPPES |
| 03506041 | Medicaid | MS | |
| 2390007 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | () | Primary |
| Provider Name | Kellen Travis Jex |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1952698532 PECOS PAC ID: 5991920613 Enrollment ID: I20140711002052 |
| Provider Name | Sarah Elizabeth Gousset |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487041505 PECOS PAC ID: 3375027675 Enrollment ID: I20260325000500 |
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