Individual provider · Type 1 NPI
Phillip Matthew Ezell, FNP-BC, AGACNP-BC
Adult Medicine Physician · Petal, MS
NPI number
1689453524
Active
Practice location
908 S George Ave
Petal, MS 39465-2077
Mailing address
670 Weathersby Rd Ste 140
Hattiesburg, MS 39402-9586
Other practice locations
- 670 Weathersby Rd Ste 140, Hattiesburg, MS 39402-9586 · (601) 318-0669
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Medicine Physician Primary | 207QA0505X | 905839 (MS) |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 905839 (MS) |
Adult Medicine Physician: The NUCC recommends this code not be used. Choose a more appropriate code.
About NPI 1689453524
Phillip Matthew Ezell, FNP-BC, AGACNP-BC's National Provider Identifier is 1689453524, issued on Sep 28, 2023. The primary taxonomy on file is Adult Medicine Physician (207QA0505X), and the practice location is in Petal, MS. The record was last updated on Jan 5, 2026.