Provider Demographics
NPI:1386658417
Name:HSU, PATRICK S (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:S
Last Name:HSU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:703 ALCORN DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CORINTH
Mailing Address - State:MS
Mailing Address - Zip Code:38834-9302
Mailing Address - Country:US
Mailing Address - Phone:662-286-0930
Mailing Address - Fax:662-287-5792
Practice Address - Street 1:703 ALCORN DR STE 110
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:MS
Practice Address - Zip Code:38834-9302
Practice Address - Country:US
Practice Address - Phone:166-241-5317
Practice Address - Fax:662-287-5792
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS10184207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00013423Medicaid
MS160000021Medicare ID - Type Unspecified
MS00013423Medicaid