Healthcare Provider Details

I. General information

NPI: 1134942345
Provider Name (Legal Business Name): URGENT SPECIALTY ASSOCIATES OF MISSISSIPPI PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2024
Last Update Date: 11/05/2024
Certification Date: 11/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

499 GLOSTER CREEK VLG STE 4
TUPELO MS
38801-4600
US

IV. Provider business mailing address

PO BOX 679276
DALLAS TX
75267-9276
US

V. Phone/Fax

Practice location:
  • Phone: 662-377-6470
  • Fax: 662-377-6330
Mailing address:
  • Phone: 855-495-1400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN D JOSEPHS
Title or Position: PRESIDENT
Credential: MD
Phone: 469-609-9908