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Individual

LAUREN AYRES BETHEA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
421 S 28TH AVE, SUITE 200, HATTIESBURG, MS 39401-7206
(601) 268-5640
(601) 261-3507
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 268-5640
(601) 579-5240

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
23276
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02655503
MS
Enumeration date
07/05/2010
Last updated
08/11/2020
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