| |
4308 Park Ten Dr, Diamondhead, MS 39525-3222 | |
(228) 255-5328 | |
(228) 255-0026 |
Full Name | |
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Type | Facility |
Speciality | Chiropractor |
Location | 4308 Park Ten Dr, Diamondhead, Mississippi |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1679740492 | NPI | - | NPPES |
02500841 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 887 (Mississippi) | Primary |
Provider Name | Desmond W Hoda |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1194896902 PECOS PAC ID: 9638243108 Enrollment ID: I20080731000467 |
Mailing Address | Practice Location Address |
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4308 Park Ten Dr, Diamondhead, MS 39525-3222 Ph: (228) 255-5328 | 4308 Park Ten Dr, Diamondhead, MS 39525-3222 Ph: (228) 255-5328 |
Desmond Wayne Hoda, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 4308 Park Ten Dr, Diamondhead, MS 39525 Phone: 228-255-5328 Fax: 228-255-0026 |