ST MICHAELS URGENT CARE OF HATTIESBURG NPI 1124459136

NPI Information

ST MICHAELS URGENT CARE OF HATTIESBURG is a family nurse practitioner in Hattiesburg, MS. ST MICHAELS URGENT CARE OF HATTIESBURG NPI is 1124459136. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3700 HARDY ST
HATTIESBURG, MS
ZIP 39402-610
Phone: (601) 602-2014
Fax: (601) 602-2015

The provider's authorized official is Marva Joyce Cooley .
The authorized official title is Credentialling Director and has the following contact phone number (601) 909-2539.

The CLIA number assigned to this NPI record is 25D2038225 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/2/2013 and was last updated on 9/6/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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