# GEORGE REGIONAL ER PHYSICIANS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043690936
- **Authorized official:** MS. KATHY FENDER (ADMINISTRATOR)
- **Authorized official phone:** (601) 947-8181

## Contact information

- **Practice address:** 859 WINTER ST, LUCEDALE, MS 39452-6603
- **Practice address phone:** (601) 947-3161
- **Practice address fax:** (601) 947-1331
- **Mailing address:** PO BOX 1007, LUCEDALE, MS 39452-1007
- **Mailing address phone:** (601) 947-1332
- **Mailing address fax:** (601) 947-1331

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | — | NULL | Yes |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/04/2015
- **Last updated:** 11/07/2016