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General NPI Number Information
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NPI Number | 1396996997
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Entity Type | Organization
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Legal Business Name | ACS EMERGENCY SERVICES OF MISSISSIPPI PROFESSIONAL ASSOCIATION
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Dates
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Enumeration Date | 10/02/2008
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Last Update Date | 09/14/2020
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Provider Practice Location Address
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Address Line | 901 E SUNFLOWER RD
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City | CLEVELAND
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State | MS
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Zip | 38732-2833
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Country | US
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Telephone | 662-846-0061
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 636232
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City | CINCINNATI
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State | OH
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Zip | 45263-6232
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Country | US
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Telephone | 800-424-3672
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Fax | 954-377-3042
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RANDAL L DABBS
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Credential | MD
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Telephone | 865-293-5210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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