| Statcare Pllc | |
|
1017 Delaware Ave Mccomb MS 39648-3827 | |
| (601) 250-1122 | |
| (601) 250-0290 |
| Full Name | Statcare Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1017 Delaware Ave, Mccomb, Mississippi |
| Authorized Official Name and Position | Debra B Kennedy (OFFICE MANAGER) |
| Authorized Official Contact | 6012501122 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Statcare Pllc Po Box 1909 Mccomb MS 39649-1909 Ph: (601) 250-1122 | Statcare Pllc 1017 Delaware Ave Mccomb MS 39648-3827 Ph: (601) 250-1122 |
| NPI Number | 1174579338 |
|---|---|
| Provider Enumeration Date | 05/26/2006 |
| Last Update Date | 10/23/2007 |
| Medicare PECOS PAC ID | 5799764965 |
|---|---|
| Medicare Enrollment ID | O20040720000687 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174579338 | NPI | - | NPPES |
| CN2774 | Other | MS | MEDICARE RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Darryl G Temple |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730168618 PECOS PAC ID: 7911968466 Enrollment ID: I20041019000996 |
| Provider Name | Jackie E Brister |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568473270 PECOS PAC ID: 2466457569 Enrollment ID: I20060925000071 |
| Provider Name | Brett B Tisdale |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699754572 PECOS PAC ID: 0941205041 Enrollment ID: I20090623000239 |
| Provider Name | Brett A Ferman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578639449 PECOS PAC ID: 4082765532 Enrollment ID: I20090624000290 |
| Provider Name | Scott F Smith |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629057427 PECOS PAC ID: 9032114137 Enrollment ID: I20090629000260 |
| Provider Name | John A Watson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1851370795 PECOS PAC ID: 3678578770 Enrollment ID: I20101004001117 |
| Provider Name | Jodi L Waller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811303670 PECOS PAC ID: 3779703905 Enrollment ID: I20141009002064 |
| Provider Name | John N Harvey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982012548 PECOS PAC ID: 0244451821 Enrollment ID: I20141023001901 |
| Provider Name | Christopher H Bracey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578084521 PECOS PAC ID: 8426321258 Enrollment ID: I20170830001450 |
| Provider Name | Melanie Robertson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427567791 PECOS PAC ID: 3678835287 Enrollment ID: I20180320000313 |
Southwest Mississippi Regional Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 215 Marion Ave, Attn Icu, Mccomb, MS 39648 Phone: 601-249-5500 Fax: 601-249-1173 | |
Hands Of Purpose Health And Wellness Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 220 W Georgia Ave, Mccomb, MS 39648 Phone: 601-324-3057 Fax: 601-980-0360 | |
Statcare Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1015 Delaware Ave, Suite C, Mccomb, MS 39648 Phone: 601-249-4777 Fax: 601-249-4776 | |
Compassionate Medical Services, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 150 Marion Ave, Mccomb, MS 39648 Phone: 407-558-0270 | |
Anazia Medical, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 120 5th Avenue, Mccomb, MS 39648 Phone: 601-249-0013 Fax: 601-249-0592 | |
Southwest Mississippi Regional Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1506 Harrison Ave, Mccomb, MS 39648 Phone: 601-250-4200 Fax: 601-250-4203 |