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NPI Code Detail

MEDICARE: PHILIP BATSON MELLEN MD

MEDICARE: PHILIP BATSON MELLEN MD
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
1207RH0005XHypertension Specialist Physician19823MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17214746OTHERMSAETNA
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1730108358
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHILIP BATSON MELLEN MD
Provider Business Mailing Address
First Line : 1800 BEACH DR
Second Line :
City : GULFPORT
State : MS
Zip : 39507-1553
Country : US
Telephone Number : 228-897-4514
Fax Number :
Provider Business Practice Location Address
First Line : 1800 BEACH DR
Second Line :
City : GULFPORT
State : MS
Zip : 39507-1553
Country : US
Telephone Number : 228-897-4514
Fax Number : 228-897-4481
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2006
Last Update Date : 09/06/2024

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Directions to “ PHILIP BATSON MELLEN MD” Practice Location

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