Individual
MR. RICHARD WAYNE GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FPMHNP
Contact information
Practice address
1 LINCOLN PARKWAY, SUITE 202, HATTIESBURG, MS 39402
(601) 288-8050
Mailing address
1 LINCOLN PARKWAY, SUITE 202, HATTIESBURG, MS 39402
(601) 288-8050
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R871707
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00203711
—
MS
05
—
891009860
—
AL
Enumeration date
06/14/2006
Last updated
11/30/2012
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