Wayne General Hospital
Organization Active NPI Neuromusculoskeletal Medicine & OMM Physician · Waynesboro, MS
NPI 1720203367 · NPPES record last updated May 18, 2015
Key facts
- NPI
- 1720203367
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Neuromusculoskeletal Medicine & OMM Physician 204D00000X
- License
- 11-288 (MS)
- Legal business name
- WAYNE GENERAL HOSPITAL
- Practice address
- 950 Matthew Dr
Waynesboro, MS 39367-2567 - Phone
- (601) 735-5151
- Fax
- (601) 735-7168
- NPI assigned
- Apr 17, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- WAYNE GENERAL HOSPITAL
Authorized official
- Name
- Mrs. Kathy Waddell
- Title
- Administrator
- Phone
- (601) 735-5151
Other NPIs on the same Medicare enrollment 7
Corporate family (same tax ID) 13
Practitioners 3
-
Karen Creel Ladnier, AGACNP
-
Aremmia D. Tanious, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040623000865 | MS | Part B Supplier - Clinic/Group Practice | 2668457581 |
Receives reassigned benefits from 51 practitioners 7 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Waynesboro, MS |
National Provider Directory
- Tax ID family
- Arthur E Medical Clinic
- Part of
- Arthur E Medical Clinic
Locations
951 Matthew Dr
Ste A
Waynesboro, MS 39367
Phone (601) 735-2401
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neuromusculoskeletal Medicine & OMM Physician |
204D00000X | 11-288 | MS | Yes |
Addresses
Primary practice location
950 Matthew Dr
Waynesboro, MS 39367-2567
Mailing address
950 Matthew Dr
P O Box 1249
Waynesboro, MS 39367-2567
Phone (601) 735-5151
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09013098 | Medicaid | MS |
Other names
- WAYNE GENERAL EEG
Other providers in Waynesboro, MS
- Wayne General Hospital
- Wayne General Hospital
- Wayne General Hospital
- Wayne General Hospital
- Wayne General Hospital
- Wayne General Hospital
- Wayne General Hospital
- Wayne General Hospital
- Wayne General Hospsital
- Samuel White
All providers in Waynesboro, MS · Neuromusculoskeletal Medicine & OMM Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 18, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.