Mary Gwindolyn Allen
Individual provider Active NPI Physician Assistant · Potts Camp, MS
NPI 1053044685 · NPPES record last updated Jul 1, 2022
Key facts
- NPI
- 1053044685
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 130 E Saint Mary Ave
Potts Camp, MS 38659-4400 - Phone
- (662) 544-1834
- NPI assigned
- Jul 1, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Physician Assistant
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
130 E Saint Mary Ave
Potts Camp, MS 38659-4400
Mailing address
130 E Saint Mary Ave
Potts Camp, MS 38659-4400
Phone (662) 544-1834
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mallen16@cbu.edu | Direct |
Other providers in Potts Camp, MS
- Alliance Healthcare System Inc
- Morgan Elizabeth Coe
- Ali Crawford
- Laura Jo Gardner
- Jennifer Leigh McMinn
All providers in Potts Camp, MS · Physician Assistant in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.