Timothy M South (NPI# 1376506741, PAC ID# 6103871967) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1376506741 |
| PAC ID by PECOS | 6103871967 |
| Professional Enrollment ID | I20050315000702 |
| Full Name | Timothy M South |
| Organization Legal Name | PREMIER MEDICAL GROUP OF MISSISSIPPI LLC |
| Address |
332 Hwy 12 W Kosciusko MS 39090 |
| Phone Number | 60120661006106 |
| Gender | M |
| Credential | NP |
| Graduation Year | 1993 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 8729973623 |
| Number of Group Practice Members | 24 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 250050 | OCH REGIONAL MEDICAL CENTER |
| 251336 | BAPTIST MEDICAL CENTER ATTALA |
| 250001 | UNIVERSITY OF MISSISSIPPI MED CENTER |
| Address | Phone | Organization |
|---|---|---|
| 332 Hwy 12 W, Kosciusko, MS 39090 | 60120661006106 | PREMIER MEDICAL GROUP OF MISSISSIPPI LLC |
| Organization Legal Name | PREMIER MEDICAL GROUP OF MISSISSIPPI LLC |
| Physicians | 26 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Crystal H Martin | Nurse Practitioner | Premier Medical Group of Mississippi LLC | 407 S Valley St, Carthage, MS 39051-4051 |
| Linda B Cockroft | Nurse Practitioner | Premier Medical Group of Mississippi LLC | 530 Veterans Memorial Dr, Kosciusko, MS 39090-3858 |
| Christi Sims | Physical Therapy | Premier Medical Group of Mississippi LLC | 130 Pkwy Plz, Kosciusko, MS 39090-3217 |
| Michael Holman | Family Medicine | Premier Medical Group of Mississippi LLC | 332 Hwy 12 W, Kosciusko, MS 39090 |
| Robert G Browning | Family Medicine | Premier Medical Group of Mississippi LLC | 332 Hwy 12 W, Kosciusko, MS 39090 |
| Sarah Putt | Occupational Therapy | Premier Medical Group of Mississippi LLC | 130 Pkwy Plz, Kosciusko, MS 39090-3217 |
| Deidra Cockroft | Physical Therapy | Premier Medical Group of Mississippi LLC | 332 Hwy 12 W, Kosciusko, MS 39090 |
| James J Withers | Family Medicine | Premier Medical Group of Mississippi LLC | 407 S Valley St, Carthage, MS 39051-4051 |
| Dorothy Fulgham | Occupational Therapy | Premier Medical Group of Mississippi LLC | 332 Hwy 12 W, Kosciusko, MS 39090 |
| Tina Mcneal | Physical Therapy | Premier Medical Group of Mississippi LLC | 332 Hwy 12 W, Kosciusko, MS 39090 |
| Street Address |
332 HWY 12 W |
| City | KOSCIUSKO |
| State | MS |
| Zip | 39090 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Craig S Howard | Diagnostic Radiology | Comprehensive Radiology Services, Pllc | 332 Hwy 12 W, Kosciusko, MS 39090-3209 |
| Cleveland A. Hudson | Diagnostic Radiology | Comprehensive Radiology Services, Pllc | 332 Hwy 12 W, Kosciusko, MS 39090-3209 |
| Michael Holman | Family Medicine | Premier Medical Group of Mississippi LLC | 332 Hwy 12 W, Kosciusko, MS 39090 |
| Robert G Browning | Family Medicine | Premier Medical Group of Mississippi LLC | 332 Hwy 12 W, Kosciusko, MS 39090 |
| Deidra Cockroft | Physical Therapy | Premier Medical Group of Mississippi LLC | 332 Hwy 12 W, Kosciusko, MS 39090 |
| Neil A Solomon | Diagnostic Radiology | Comprehensive Radiology Services, Pllc | 332 Hwy 12 W, Kosciusko, MS 39090-3209 |
| Richard F Mccarthy | Diagnostic Radiology | Comprehensive Radiology Services, Pllc | 332 Hwy 12 W, Kosciusko, MS 39090-3209 |
| Steven G Cunningham | Diagnostic Radiology | Comprehensive Radiology Services, Pllc | 332 Hwy 12 W, Kosciusko, MS 39090-3209 |
| Scott T Boyette | Diagnostic Radiology | Comprehensive Radiology Services, Pllc | 332 Hwy 12 W, Kosciusko, MS 39090-3209 |
| Cameron Guild | Interventional Cardiology | Medical Foundation of Central Mississippi Inc | 332 Hwy 12 W, Kosciusko, MS 39090-3209 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dorothy Fulgham | Occupational Therapy | Premier Medical Group of Mississippi LLC | 332 Hwy 12 W, Kosciusko, MS 39090 |
| Tina Mcneal | Physical Therapy | Premier Medical Group of Mississippi LLC | 332 Hwy 12 W, Kosciusko, MS 39090 |
| Krista B Blaylock | Nurse Practitioner | Premier Medical Group of Mississippi LLC | 332 Hwy 12 W, Kosciusko, MS 39090 |
| Stephen C Hammack | Family Medicine | Premier Medical Group of Mississippi LLC | 332 Hwy 12 W, Kosciusko, MS 39090 |
| Hannah Cooper | Nurse Practitioner | Premier Medical Group of Mississippi LLC | 332 Hwy 12 W, Kosciusko, MS 39090 |
| Robert Kirtis Greenlee | Nurse Practitioner | Premier Medical Group of Mississippi LLC | 332 Hwy 12 W, Kosciusko, MS 39090 |
| Ray Cockroft | Occupational Therapy | Premier Medical Group of Mississippi LLC | 332 Hwy 12 W, Kosciusko, MS 39090 |
| Benjamin T Carter | Family Medicine | Premier Medical Group of Mississippi LLC | 332 Hwy 12 W, Kosciusko, MS 39090 |
| Breck Richardson | General Practice | Premier Medical Group of Mississippi LLC | 332 Hwy 12 W, Kosciusko, MS 39090 |
| Patricia A Rush | Audiologist | Premier Medical Group of Mississippi LLC | 332 Hwy 12 W, Kosciusko, MS 39090 |
| Find all physicians in zip 39090 | |||
| City | KOSCIUSKO |
| Zip Code | 39090 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | KOSCIUSKO + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Timothy M South.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.