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NPI Code Detail

MEDICARE: KELLY S SEGARS MD PC

MEDICARE: KELLY S SEGARS MD PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist12314MS
2174400000XSpecialist10016MS

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
5011800024OTHERMSRAILROAD MEDICARE
11P00123795OTHERMSRAILROAD MEDICARE
18080117421OTHERMSRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21609871607OTHERMSNPI
3487623030OTHERMSBCBS
4587922966OTHERMSBCBS
61649429481OTHERMSNPI
71750386488OTHERMSNPI
85121500528OTHERMSPTAN
9MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
105121500341OTHERMSPTAN
12587286250OTHERMSBCBS
13MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
14MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
151750387890OTHERMSNPI
16500001207OTHERMSPTAN
17MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
19418807663OTHERMSBCBS
20428559600OTHERMSBLUE CROSS BLUE SHIELD
21MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
221124298849OTHERMSNPI
23420866905OTHERMSBCBS

General Provider Information

NPI Number : 1073566550
Entity Type Code : Organization
Provider Name (Legal Business Name) : KELLY S SEGARS MD PC
Provider Business Mailing Address
First Line : 1507 W QUITMAN ST
Second Line :
City : IUKA
State : MS
Zip : 38852-1132
Country : US
Telephone Number : 662-423-1000
Fax Number : 662-423-1316
Provider Business Practice Location Address
First Line : 1507 W QUITMAN ST
Second Line :
City : IUKA
State : MS
Zip : 38852-1132
Country : US
Telephone Number : 662-423-1000
Fax Number : 662-423-1316
Authorized Official
Title or Position : BILLING MANAGER
Name : MONA A MCWILLIAMS
Credential :
Telephone Number : 662-423-1000
Provider Enumeration Date : 05/18/2006
Last Update Date : 09/10/2012

Similar Medicare Providers

1609871607 — DR. KELLY S SEGARS JR. M.D.
Practice Location Address:
1507 W QUITMAN ST
IUKA, MS
38852-1132
Practice Phone: 662-423-1000
Practice Fax: 662-423-1316
1750386488 — DR. MARGARET M GLYNN M.D.
Practice Location Address:
1507 W QUITMAN ST
IUKA, MS
38852-1132
Practice Phone: 662-423-1000
Practice Fax: 662-423-1316
1437155918 — MR. RANDY L MCDUFFY
Practice Location Address:
1507 W QUITMAN ST
IUKA, MS
38852-1132
Practice Phone: 662-423-1000
Practice Fax: 662-423-1316
1750387890 — MRS. DIANE L DAVIS NURSE PRACTITIONER
Practice Location Address:
1507 W QUITMAN ST
IUKA, MS
38852-1132
Practice Phone: 662-423-1000
Practice Fax: 662-423-1316
1497809156 — BURNS INC
Practice Location Address:
1519 W QUITMAN ST
IUKA, MS
38852-1132
Practice Phone: 662-423-3628
Practice Fax: 662-423-3620
1013189927 — ELIZABETH SENN DAWSON CRNP
Practice Location Address:
1507 W QUITMAN ST
IUKA, MS
38852-1132
Practice Phone: 662-423-1000
Practice Fax:

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