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Individual

DR. HAL T LIDDELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
139 FAIRFIELD DR, HATTIESBURG, MS 39402-1303
(601) 450-2401
(601) 450-2433
Mailing address
139 FAIRFIELD DR, HATTIESBURG, MS 39402-1303
(601) 450-2401
(601) 450-2434

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
09147
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1023032497
MS
01
509218YTSR
MEDICARE PTAN
MS
Enumeration date
07/27/2006
Last updated
10/04/2016
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