Individual
HEATHER HUGULEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1701 WHITE ST, MCCOMB, MS 39648
(601) 249-4218
(601) 249-4234
Mailing address
1701 WHITE ST, PO BOX 768, MCCOMB, MS 39648
(601) 249-4218
(601) 249-4234
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00250
MS
363AM0700X
Medical Physician Assistant
PA00250
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07877328
—
MS
Enumeration date
08/24/2015
Last updated
03/03/2022
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