Organization
PROFESSIONAL PATHOLOGY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN NELSON MD (HEAD PHYSICIAN)
(228) 432-1571
Entity
Organization
Contact information
Practice address
150 REYNOIR ST, BILOXI, MS 39530-4130
(228) 432-1571
(228) 436-1256
Mailing address
5700 SOUTHWYCK BLVD, TOLEDO, OH 43614-1509
(800) 288-8325
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05488071
—
MS
01
—
CM1404
RAILROAD
—
Enumeration date
08/24/2005
Last updated
10/18/2024
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