# FORREST COUNTY GENERAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** FAMILY MEDICINE RESIDENCY CLINIC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699267625
- **Authorized official:** MR. DAVID PYLATE (PATIENT ACCOUNTS MANAGER)
- **Authorized official phone:** (601) 288-1864

## Contact information

- **Practice address:** 415 S 28TH AVE FL 1, HATTIESBURG, MS 39401-7246
- **Practice address phone:** (601) 579-3300
- **Practice address fax:** (601) 268-5738
- **Mailing address:** PO BOX 15722, HATTIESBURG, MS 39404-5722
- **Mailing address phone:** (601) 288-1823
- **Mailing address fax:** (601) 288-1877

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/05/2018
- **Last updated:** 06/05/2018