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1 Lincoln Pkwy Ste 202 Hattiesburg MS 39402-3261 | |
| (601) 288-8050 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1 Lincoln Pkwy Ste 202, Hattiesburg, Mississippi |
| Authorized Official Name and Position | Debbie F Sanford (ADMINSTRATOR) |
| Authorized Official Contact | 6012884800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1 Lincoln Pkwy Ste 202 Hattiesburg MS 39402-3261 Ph: (601) 288-8050 | 1 Lincoln Pkwy Ste 202 Hattiesburg MS 39402-3261 Ph: (601) 288-8050 |
| NPI Number | 1447356902 |
|---|---|
| Provider Enumeration Date | 09/15/2006 |
| Last Update Date | 01/15/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447356902 | NPI | - | NPPES |
| 09015143 | Medicaid | MS |
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