Mary L Feagans PA

NPI 1871572578

Information of Mary L Feagans PA

The NPI 1871572578 is an Individual type. NPI No 1871572578 belongs to Mary L Feagans. Mary L Feagans PA specializes in Physician Assistant. She is practising at 415 S 28th Ave, Hattiesburg, Mississippi 39401. You can also contact him via phone number (601) 268-5800.

Practice address located

  • 415 S 28th Ave
  • Hattiesburg, Mississippi 39401
  • (601) 268-5800
  • (601) 268-5800

Mailling address located

  • 415 S 28th Ave
  • Hattiesburg, Mississippi 39401
  • (601) 268-5800
  • (601) 261-3530
Mary L Feagans PA is PECOS enrolled.
NPI No 1871572578
Primary Taxonomy
Specialty of the provider
PrimaryTaxonomy CodeClassificationLicense NumberLicense State
Yes363A00000XPhysician AssistantPA00165Mississippi
No363AM0700XMedicalPA200038Louisiana
Identifier for this provider
StateIdentifierTypeIssuer
MS05202536Medicaidn/a
LA1591149Medicaidn/a
MS302I978316OtherMEDICARE PTAN
MS3122240OtherUNITED HEALTHCARE
LA57698P692Medicare ID-Type Unspecifiedn/a
MS8740773OtherCIGNA
MS9464394OtherAETNA
LAQ49293Medicare UPINn/a
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