Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Miles Moore Debardeleben, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1417419094

Miles Moore Debardeleben, MD is an Internal Medicine in Jackson, Mississippi. Graduated from University of Mississippi School of Medicine in 2019, 7 years ago. Practices with Oak Mountain Group Services, LLC, a 62-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
7
Trained at
University of Mississippi School of Medicine
Licensed in
MS
In the registry since
2019
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2500 N State St
Jackson, MS 39216-4500
Phone: (601) 984-5601
Fax: (601) 984-6665
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence T-3759 (MS)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1417419094
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 3, 2019
Last updated in NPPESApril 13, 2020
Certification dateApril 13, 2020
Mailing address2500 N State St, Jackson, MS 39216-4500

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolUNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
Graduated 2019 (7 years in practice)
Group practice Oak Mountain Group Services, Llc — 62 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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