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PATHWAY HEALTHCARE- MISSISSIPPI LLC NPI 1013425503


NPI Information

NPI: 1013425503
Provider Name: PATHWAY HEALTHCARE- MISSISSIPPI LLC

Other Name: PATHWAY HEALTHCARE LAUREL MS

Classification: Family Medicine - 207QA0401X
Entity Type: Organization

Specialization: Addiction Medicine

CLIA Number: 01D1087944

Address:
1 MEDICAL PLAZA DR
VICKSBURG, MS
ZIP 39180
Phone: (601) 883-0264
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PATHWAY HEALTHCARE- MISSISSIPPI LLC is an addiction medicine family medicine in Vicksburg, MS. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. PATHWAY HEALTHCARE- MISSISSIPPI LLC NPI is 1013425503. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Pathway Healthcare Laurel Ms.

The provider's business location address is:

1 MEDICAL PLAZA DR
VICKSBURG, MS
ZIP 39180-187
Phone: (601) 883-0264
Fax: (601) 883-0266

The provider's authorized official is Andrew Turner .
The authorized official title is President/coo and has the following contact phone number (205) 208-9312.

The CLIA number assigned to this NPI record is 01D1087944 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/18/2018 and was last updated on 2/23/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207QA0401XFamily MedicineAddiction MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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