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NPI Code Detail

MEDICARE: MARY L FEAGANS PA

MEDICARE: MARY L FEAGANS PA
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
1363AM0700XMedical Physician AssistantPA200038LA
2363A00000XPhysician AssistantPA00165MS

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
5302I978316OTHERMSMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
39464394OTHERMSAETNA
43122240OTHERMSUNITED HEALTHCARE
68740773OTHERMSCIGNA

General Provider Information

NPI Number : 1871572578
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY L FEAGANS PA
Provider Business Mailing Address
First Line : 415 S 28TH AVE
Second Line :
City : HATTIESBURG
State : MS
Zip : 39401-7246
Country : US
Telephone Number : 601-268-5800
Fax Number : 601-261-3530
Provider Business Practice Location Address
First Line : 415 S 28TH AVE
Second Line :
City : HATTIESBURG
State : MS
Zip : 39401-7246
Country : US
Telephone Number : 601-268-5800
Fax Number : 601-261-3530
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2006
Last Update Date : 10/24/2012

Similar Medicare Providers

1174887319 — DAVID MOTANYA M.D
Practice Location Address:
415 S 28TH AVE
HATTIESBURG, MS
39401-7246
Practice Phone: 360-261-3606
Practice Fax: 601-579-5383
1750385365 — MRS. SUSAN R OGLESBEE FNP
Practice Location Address:
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Practice Phone: 601-268-5680
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1376545145 — BRIAN S RIFKIN MD
Practice Location Address:
415 S 28TH AVE
HATTIESBURG, MS
39401-7246
Practice Phone: 601-268-5700
Practice Fax: 601-268-5977
1992790463 — DR. KEVIN BRADLEY BARKER M.D.
Practice Location Address:
415 S 28TH AVE
HATTIESBURG, MS
39401-7246
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Practice Fax: 601-268-5778
1467422436 — LOYD B HIGH M.D.
Practice Location Address:
415 S 28TH AVE
HATTIESBURG, MS
39401-7246
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Practice Fax: 601-268-5777
1003884305 — CARL SCOTT RAMSEY M.D.
Practice Location Address:
415 S 28TH AVE
HATTIESBURG, MS
39401-7246
Practice Phone: 601-261-3606
Practice Fax:

Directions to “ MARY L FEAGANS PA” Practice Location

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