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General NPI Number Information
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NPI Number | 1538200209
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Entity Type | Organization
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Legal Business Name | WESLEY PHYSICIAN SERVICES LLC
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 5003 HARDY ST STE 200
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City | HATTIESBURG
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State | MS
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Zip | 39402-1331
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Country | US
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Telephone | 601-261-5700
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Fax | 601-261-5777
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Provider Business Mailing Address
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Address Line | PO BOX 689022
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City | FRANKLIN
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State | TN
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Zip | 37068-9022
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Country | US
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Telephone | 615-465-7361
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Fax | 615-628-6877
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Authorized Official
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Title or Position | DIRECTOR PROVIDER ENROLLMENT
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Name | KRISTINA MUSIC
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Credential |
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Telephone | 877-892-9815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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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 | 103T00000X
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Taxonomy Name | Psychologist
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 207UN0901X
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Taxonomy Name | Nuclear Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 2084F0202X
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Taxonomy Name | Forensic Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #15
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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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