Provider Demographics
NPI:1346637121
Name:ASCLEPIUS HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:ASCLEPIUS HEALTH SERVICES, LLC
Other - Org Name:AHS, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:D
Authorized Official - Last Name:PRATT
Authorized Official - Suffix:
Authorized Official - Credentials:D O
Authorized Official - Phone:662-202-7207
Mailing Address - Street 1:P. O. BOX 509
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655
Mailing Address - Country:US
Mailing Address - Phone:662-202-7207
Mailing Address - Fax:
Practice Address - Street 1:704 WHISPERING BEND
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655
Practice Address - Country:US
Practice Address - Phone:662-202-7207
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-20
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS20084208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty