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2117 Broadway Dr Hattiesburg MS 39402-3210 | |
| (601) 288-8050 | |
| (601) 288-8058 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 2117 Broadway Dr, Hattiesburg, Mississippi |
| Authorized Official Name and Position | Debbie F Sanford (VP OF BEHAVIORAL HEALTH) |
| Authorized Official Contact | 6012884801 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2117 Broadway Dr Hattiesburg MS 39402-3210 Ph: (601) 288-8050 | 2117 Broadway Dr Hattiesburg MS 39402-3210 Ph: (601) 288-8050 |
| NPI Number | 1275710212 |
|---|---|
| Provider Enumeration Date | 01/22/2008 |
| Last Update Date | 07/17/2024 |
| Certification Date | 07/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275710212 | NPI | - | NPPES |
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