Fussell, Stephanie

Fussell, Stephanie is an individual health care provider with primary practice located at 1340 Broad Ave Ste 330 , Gulfport MS 39501-2464. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine, Allopathic & Osteopathic Physicians / Hematology & Oncology, Allopathic & Osteopathic Physicians / Medical Oncology. Allopathic & Osteopathic Physicians / Medical Oncology is her primary health care specialty. Fussell, Stephanie can be contacted via phone (228) 575-1234.

Contact Information

Primary practice address
1340 Broad Ave Ste 330 Gulfport MS 39501-2464
Phone: (228) 575-1234
Fax: (228) 867-4828
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine 207RH0002X 16995 Mississippi
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 00025974 Alabama
Allopathic & Osteopathic Physicians / Medical Oncology 207RX0202X 16995 Mississippi

Profile Details

NPI number 1073569018
LBN Legal business name Fussell, Stephanie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 25th, 2006
Last updated Jun 12th, 2024 - about last year

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 1073569018 NPPES
Alabama Other 51523039 BLUE CROSS ID#
Alabama MEDICAID 529501680 BLUE CROSS ID#
Alabama Other P00122585 BLUE CROSS ID#
Alabama MEDICAID 00236384 BLUE CROSS ID#

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