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PHILLIP MATTHEW EZELL FNP-BC AGACNP-BC NPI 1689453524


NPI Information

NPI: 1689453524
Provider Name: PHILLIP MATTHEW EZELL, FNP-BC, AGACNP-BC
Classification: Family Medicine - 207QA0505X
Entity Type: Individual

Specialization: Adult Medicine

PECOS Registration: Yes

Address:
908 S GEORGE AVE
PETAL, MS
ZIP 39465
Phone: (601) 544-7441
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Phillip Matthew Ezell, FNP-BC, AGACNP-BC is an adult medicine family medicine in Petal, MS with 2 years of experience. The provider is the National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code. Phillip Matthew Ezell, FNP-BC, AGACNP-BC NPI is 1689453524. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF SOUTH ALABAMA COLLEGE OF MEDICINE
Graduation Year:2022

The provider's business location address is:

908 S GEORGE AVE
PETAL, MS
ZIP 39465-077
Phone: (601) 544-7441

The NPI 1689453524 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/28/2023 and was last updated on 9/28/2023.


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
1207RC0200XInternal MedicineCritical Care Medicine905839MISSISSIPPINo
2207QA0505XFamily MedicineAdult Medicine905839MISSISSIPPIYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.