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Organization

SOUTH MISSISSIPPI EMERGENCY PHYSICIANS PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN NELSON DO (MEDICAL DIRECTOR)
(601) 288-7000
Entity
Organization

Contact information

Practice address
6051 HIGHWAY 49, HATTIESBURG, MS 39401-7200
(601) 288-2010
(601) 288-2193
Mailing address
PO BOX 635614, CINCINNATI, OH 45263-5614
(601) 288-2010
(601) 288-2193

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09016106
MS
01
CK4284
RRGA
MS
Enumeration date
06/21/2006
Last updated
06/23/2008
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