Healthcare Provider Details

I. General information

NPI: 1841404985
Provider Name (Legal Business Name): NESHOBA PHYSICIAN BILLING SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 HOLLAND AVE
PHILADELPHIA MS
39350-2161
US

IV. Provider business mailing address

PO BOX 976
PHILADELPHIA MS
39350-0976
US

V. Phone/Fax

Practice location:
  • Phone: 601-656-9460
  • Fax: 601-656-2010
Mailing address:
  • Phone: 601-656-9460
  • Fax: 601-656-2010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SCOTT HESTER MCNAIR
Title or Position: CFO
Credential:
Phone: 601-663-1233