Individual
DR. SOPHY H MANGANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
301 S 28TH AVE, HATTIESBURG, MS 39401-7233
(601) 288-1700
(601) 288-1715
Mailing address
PO BOX 15158, HATTIESBURG, MS 39404-5158
(601) 288-1700
(601) 288-1715
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
125053930
IL
2085R0001X
Radiation Oncology Physician
Primary
22147
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02486090
—
MS
05
—
141656
—
AL
01
—
P01454791
RAILROAD MEDICARE PTAN
MS
Enumeration date
07/09/2008
Last updated
07/03/2024
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