Organization
FOOT CLINIC OF HATTIESBURG, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN PONTON DPM (OWNER)
(601) 264-5793
Entity
Organization
Contact information
Practice address
710 S 28TH AVE, STE B, HATTIESBURG, MS 39402-2585
(601) 264-5793
Mailing address
710 S 28TH AVE, STE B, HATTIESBURG, MS 39402-2585
(601) 264-5793
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
80087
MS
Other
Enumeration date
10/05/2006
Last updated
08/22/2020
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