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General NPI Number Information
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NPI Number | 1275566515
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Entity Type | Organization
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Legal Business Name | PIONEER HEALTH SERVICES, INC
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 06/02/2008
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Provider Practice Location Address
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Address Line | 301 8TH AVE SW
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City | MAGEE
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State | MS
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Zip | 39111-3967
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Country | US
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Telephone | 601-849-6440
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Fax | 601-849-7557
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Provider Business Mailing Address
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Address Line | PO BOX 1100
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City | MAGEE
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State | MS
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Zip | 39111-1100
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Country | US
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Telephone | 601-849-6440
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Fax | 601-849-7557
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSEPH S MCNULTY II
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Credential | CRT
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Telephone | 601-849-4112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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