# MAHESH MEHTA MD PLLC

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

## Provider details

- **NPI number:** 1710562392
- **Authorized official:** ROBIN HAIDO (CREDENTIALING MANAGER)
- **Authorized official phone:** (601) 968-8161

## Contact information

- **Practice address:** 27190 HIGHWAY 28, HAZLEHURST, MS 39083-2224
- **Practice address phone:** (601) 944-1717
- **Practice address fax:** (601) 944-9780
- **Mailing address:** 27190 HIGHWAY 28, HAZLEHURST, MS 39083-2224

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/15/2021
- **Last updated:** 03/15/2021