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General NPI Number Information
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NPI Number | 1780025809
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Entity Type | Individual
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Provider Name | BILLY PEARSON NP
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Gender | Male
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Dates
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Enumeration Date | 07/17/2013
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Last Update Date | 07/17/2013
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Provider Practice Location Address
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Address Line | 1560 SUMRALL RD
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City | COLUMBIA
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State | MS
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Zip | 39429-2654
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Country | US
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Telephone | 601-736-6303
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 281030
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City | ATLANTA
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State | GA
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Zip | 30384-1030
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Country | US
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Telephone | 904-482-1070
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Fax | 904-482-1077
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R858322
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License Number State | MS
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