Feagans, Mary L

Feagans, Mary L is an individual health care provider with primary practice located at 415 S 28Th Ave , Hattiesburg MS 39401-7246. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Feagans, Mary L can be contacted via phone (601) 268-5800.

Contact Information

Primary practice address
415 S 28Th Ave Hattiesburg MS 39401-7246
Phone: (601) 268-5800
Fax: (601) 261-3530
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA200038 Louisiana
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA00165 Mississippi

Profile Details

NPI number 1871572578
LBN Legal business name Feagans, Mary L
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 11th, 2006
Last updated Oct 24th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871572578 NPPES
Louisiana MEDICAID 1591149
Louisiana MEDICAID 05202536
Louisiana Other 9464394
Louisiana Other 3122240
Louisiana Other 302I978316
Louisiana Other 8740773

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