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OTAIGBE SOUTHERN MEDICAL CARE PLLC NPI 1033537469


NPI Information

NPI: 1033537469
Provider Name: OTAIGBE SOUTHERN MEDICAL CARE, PLLC

Doing Business As: SOUTHERN MEDICAL CARE, PLLC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 25D0980160

Address:
6600 U S HIGHWAY 98
SUITE B
HATTIESBURG, MS
ZIP 39402
Phone: (601) 261-2727
Get Directions

OTAIGBE SOUTHERN MEDICAL CARE, PLLC is a family medicine in Hattiesburg, MS. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. OTAIGBE SOUTHERN MEDICAL CARE, PLLC NPI is 1033537469. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Southern Medical Care, Pllc.

The provider's business location address is:

6600 U S HIGHWAY 98
SUITE B
HATTIESBURG, MS
ZIP 39402-441
Phone: (601) 261-2727
Fax: (601) 261-9847

The provider's authorized official is Mechelle Duckworth .
The authorized official title is Ceo and has the following contact phone number (601) 296-3150.

The CLIA number assigned to this NPI record is 25D0980160 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/2/2014 and was last updated on 4/2/2014.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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