RH Hospitalist Medicine of Jefferson Davis LLC

Organization Active NPI Hospitalist Physician · Prentiss, MS

NPI 1174385355 · NPPES record last updated Sep 26, 2024

Key facts

NPI
1174385355
Entity type
Organization (NPI type 2)
Primary specialty
Hospitalist Physician 208M00000X
Legal business name
RH HOSPITALIST MEDICINE OF JEFFERSON DAVIS LLC
Practice address
1102 Rose St
Prentiss, MS 39474-5200
Phone
(601) 792-4276
NPI assigned
Jan 24, 2024
Organization subpart
No

Authorized official

Name
Jennifer Kathryn Wakeford
Title
Entrprise Cfo
Phone
(205) 901-5103

Practitioners 58

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 58

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MS

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20240423003254 MS Part B Supplier - Clinic/Group Practice 6103265145 Receives reassigned benefits from 58 practitioners
Practice locations: Prentiss, MS

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208M00000X Yes

Addresses

Primary practice location

1102 Rose St
Prentiss, MS 39474-5200

Mailing address

PO Box 7058
Tupelo, MS 38802-7058

Other providers in Prentiss, MS

All providers in Prentiss, MS · Hospitalist Physician in Mississippi

Sources for this page

Verify at the official NPI Registry.