Individual
OMELIA ELIZABETH DANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
82 SAINT ANNES DR, HATTIESBURG, MS 39401-8253
(601) 342-1411
Mailing address
82 SAINT ANNES DR, HATTIESBURG, MS 39401-8253
(601) 342-1411
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16861
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00122376
—
MS
01
—
1559186
AMERICAN ADMIN GROUP
MS
Enumeration date
08/03/2006
Last updated
01/06/2022
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