Individual
DR. KIRK J BANQUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6051 U S HIGHWAY 49, HATTIESBURG, MS 39401-7200
(601) 288-2690
(601) 288-2695
Mailing address
PO BOX 16389, FGH TRAUMA SURGERY CLINIC, HATTIESBURG, MS 39404-6389
(601) 288-2690
(601) 288-2695
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
10240
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00110971
—
MS
Enumeration date
06/13/2006
Last updated
10/26/2015
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