Internal Medicine of Long Beach PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

15183 Issued in MS

Legal business name

INTERNAL MEDICINE OF LONG BEACH PLLC

Practice address

2 Tower PLZ
Pineville Road Suite E
Long Beach, MS 39560-3900

Phone

(228) 575-4374

Fax

(228) 575-4303

NPI assigned

Dec 26, 2006

Last updated

Feb 7, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Harris B Evans, M.D.

Title

Owner

Phone

(228) 575-4374

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202342400000",
    "number": "1073678520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 TOWER PLZ",
            "address_2": "PINEVILLE ROAD SUITE E",
            "city": "LONG BEACH",
            "state": "MS",
            "postal_code": "395603900",
            "telephone_number": "228-575-4374",
            "fax_number": "228-575-4303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 TOWER PLZ",
            "address_2": "PINEVILLE ROAD SUITE E",
            "city": "LONG BEACH",
            "state": "MS",
            "postal_code": "395603900",
            "telephone_number": "228-575-4374",
            "fax_number": "228-575-4303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE OF LONG BEACH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2008-02-07",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "HARRIS",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "228-575-4374",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "15183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08603563",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Long Beach, MS
• Providers in Long Beach, MS by specialty
• Internal Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.