James Wilson Speck, M.D

Individual provider Active NPI Family Medicine Physician · University, MS

NPI 1124031414 · NPPES record last updated Nov 5, 2021

Key facts

NPI
1124031414
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
05496 (MS)
Practice address
Student Health Service
Rebel Drive
University, MS 38677
Phone
(662) 915-7274
Fax
(662) 915-5292
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 05496 MS Yes

Addresses

Primary practice location

Student Health Service
Rebel Drive
University, MS 38677

Mailing address

PO Box 1848
University, MS 38677-1848
Phone (662) 915-7274

Other providers in University, MS

All providers in University, MS · Family Medicine Physician in Mississippi

Sources for this page

Verify at the official NPI Registry.