Individual
KATHARYN MARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 268-5650
(601) 579-5212
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 264-6000
(601) 579-5212
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00912
MS
Other
Enumeration date
04/23/2025
Last updated
07/29/2025
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