PHILLIP M. EZELL FNP-BC, AGACNP-BC – NPI #1689453524
Family Medicine

The NUCC recommends this code not be used. Choose a more appropriate code.

Health Care Provider Taxonomy Code for Family Medicine

PHILLIP EZELL is a physician located in PETAL, MS. NPPES has assigned the NPI number 1689453524 to PHILLIP EZELL on September 28, 2023. It is a Type-1 NPI, indicating this NPI number is associated with an individual. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207QA0505X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine, specializing in Adult Medicine

The NPI profile was last updated on Jan 05, 2026. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PHILLIP EZELL below.

NPI Profile for
PHILLIP M. EZELL

NPI Number
1689453524
Enumeration Date

(more than 2 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
PHILLIP M. EZELL
Credentials
FNP-BC, AGACNP-BC
Primary location
908 S GEORGE AVE
PETAL, MS 39465-2077
Phone: (601) 544-7441 Fax:
1 Other location(s):
670 Weathersby Rd Ste 140
Hattiesburg, MS 39402-9586
Phone: (601) 318-0669
Fax: (601) 994-6001
Mailing address
670 WEATHERSBY RD STE 140
HATTIESBURG, MS 39402-9586
Phone: (601) 318-0669 Fax: (601) 994-6001
Sole Proprietor
No
Updated
Certification Date
Jan 05, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207QA0505X
- Family Medicine / Adult Medicine (Primary)		 MS 905839
207RC0200X
- Internal Medicine / Critical Care Medicine		 MS 905839

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Additional Information

Education
UNIVERSITY OF SOUTH ALABAMA COLLEGE OF MEDICINE - Graduated 2022
Accepts Medicare
This provider accepts Medicare-approved amount as payment in full. The Medicare-approved amount is the total the provider can be paid. When a provider accepts the Medicare-approved amount as payment, you won't be billed for more than the Medicare deductible & coinsureance.
Medicare Ordering & Referring
Provider can:
  • Refer to Part B
  • Order Durable Medical Equipment
  • Refer to Home Health Agency
  • Order Power Mobility Devices

Why is my NPI data (personal information) being displayed publicly?
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How do I correct or change the NPI data displayed here?
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Can I hide my NPI profile from the public?
Unfortunately, No. The NPPES discloses health care provider data under the Freedom of Information Act to the public, which means anyone may request such information directly from the National Plan & Provider Enumeration System. See the complete CMS Data Dissemination Notice here.