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FORREST COUNTY GENERAL HOSPITAL NPI 1699267625


NPI Information

NPI: 1699267625
Provider Name: FORREST COUNTY GENERAL HOSPITAL

Doing Business As: FAMILY MEDICINE RESIDENCY CLINIC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 25D2150882

Address:
415 S 28TH AVE FL 1
HATTIESBURG, MS
ZIP 39401
Phone: (601) 579-3300
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FORREST COUNTY GENERAL HOSPITAL 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. FORREST COUNTY GENERAL HOSPITAL NPI is 1699267625. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Family Medicine Residency Clinic.

The provider's business location address is:

415 S 28TH AVE FL 1
HATTIESBURG, MS
ZIP 39401-246
Phone: (601) 579-3300
Fax: (601) 268-5738

The provider's authorized official is David Pylate .
The authorized official title is Patient Accounts Manager and has the following contact phone number (601) 288-1864.

The CLIA number assigned to this NPI record is 25D2150882 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/5/2018 and was last updated on 6/5/2018.


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

Other Identifiers

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

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
16012OTHERSSI GROUP

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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