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General NPI Number Information
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NPI Number | 1033366174
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Entity Type | Organization
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Legal Business Name | PARKWAY MEDICAL GROUP INC
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Dates
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Enumeration Date | 08/20/2008
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Last Update Date | 08/22/2008
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Provider Practice Location Address
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Address Line | 2503 GLENDALE AVE
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City | HATTIESBURG
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State | MS
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Zip | 39401-1073
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Country | US
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Telephone | 601-582-5805
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Fax | 601-582-5806
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Provider Business Mailing Address
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Address Line | 2503 GLENDALE AVE
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City | HATTIESBURG
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State | MS
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Zip | 39401-1073
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Country | US
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Telephone | 601-582-5805
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Fax | 601-582-5806
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Authorized Official
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Title or Position | CEO/ MEDICAL DIRECTOR
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Name | DR. AKWASI A AMPONSAH
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Credential | MD
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Telephone | 601-582-5805
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 17488
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License Number State | MS
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