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14 Orleans Dr Hattiesburg MS 39402-8674 | |
| (501) 450-8000 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | General Practice |
| Location | 14 Orleans Dr, Hattiesburg, Mississippi |
| Authorized Official Name and Position | Debbie Brewer (DIRECTOR OF PROVIDER ENROLLMENT) |
| Authorized Official Contact | 6154657000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
14 Orleans Dr Hattiesburg MS 39402-8674 Ph: (501) 450-8000 | 14 Orleans Dr Hattiesburg MS 39402-8674 Ph: (501) 450-8000 |
| NPI Number | 1326003856 |
|---|---|
| Provider Enumeration Date | 04/18/2006 |
| Last Update Date | 08/21/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326003856 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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