Healthcare Provider Details

I. General information

NPI: 1780504217
Provider Name (Legal Business Name): HEAL ALL WOUND CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 HIGHWAY 30 STE D
SAINT GABRIEL LA
70776-5015
US

IV. Provider business mailing address

660 LAKELAND EAST DR STE 210
FLOWOOD MS
39232-9777
US

V. Phone/Fax

Practice location:
  • Phone: 225-314-9314
  • Fax: 222-398-5022
Mailing address:
  • Phone: 601-351-9875
  • Fax: 888-398-1151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY POYTHRESS
Title or Position: VP OF BILLING & CREDENTIALING
Credential:
Phone: 601-665-4162