Individual
DR. ROBERT A DESANTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1203 AVE B, ELLISVILLE, MS 39437-2080
(601) 477-8553
(601) 649-9944
Mailing address
PO BOX 247, LAUREL, MS 39441-0247
(601) 649-9904
(601) 649-9944
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
13169
MS
207V00000X
Obstetrics & Gynecology Physician
31288
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00119497
—
MS
Enumeration date
06/05/2006
Last updated
03/14/2024
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