MEDICARE: ANNA ELIZABETH CASE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	31550	MS
2	207R00000X	Internal Medicine Physician	31550	MS

General Provider Information

NPI Number	:	1831659416
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA ELIZABETH CASE

Provider Business Mailing Address
First Line	:	415 S 28TH AVE
Second Line	:
City	:	HATTIESBURG
State	:	MS
Zip	:	39401-7246
Country	:	US
Telephone Number	:	601-264-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	704 S 5TH ST
Second Line	:
City	:	COLLINS
State	:	MS
Zip	:	39428-4147
Country	:	US
Telephone Number	:	601-765-4414
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2019
Last Update Date	:	08/19/2024

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