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Organization
VEIN INSTITUTE OF SOUTH MISSISSIPPI PLLC
Active
Organization
VEIN INSTITUTE OF SOUTH MISSISSIPPI PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN KEITH THOMPSON DO (OWNER)
(601) 467-5340
Entity
Organization
Contact information
Practice address
6169 U S HIGHWAY 98, HATTIESBURG, MS 39402-8631
(601) 335-8368
Mailing address
6169 U S HIGHWAY 98, HATTIESBURG, MS 39402-8631
(601) 335-8368
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
NULL
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19031
MISSISSIPPI STATE BOARD OF MEDICAL LICENSURE
MS
01
—
800456806
DRIVERS LICENSE - MISSISSIPPI MOTOR VEHICLE COMMISSION
MS
Enumeration date
12/08/2021
Last updated
12/08/2021
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