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

MS. Mary S Missak, MD

Individual provider Internal Medicine Physician · NPI 1962507061

MS. Mary S Missak, MD is an Internal Medicine in Southaven, Mississippi. Qualified in 1979, 47 years ago. Practices with Baptist Memorial Hospital-Desoto, Inc, a 9-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Mississippi.

Years since qualifying
47
Licensed in
MS
In the registry since
2006
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

7680 Airways Blvd
Southaven, MS 38671-5304
Phone: (662) 349-1999
Fax: (662) 349-9734
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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 16715 (MS)

Record details

NPI number1962507061
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedSeptember 13, 2006
Last updated in NPPESJuly 8, 2007

Medicare enrollment

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

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 1979 (47 years in practice)
Group practice Baptist Memorial Hospital-Desoto, Inc. — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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