Organization
WOMENS PAVILION OF SOUTH MISSISSIPPI, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. HOLLEY JOHNSON MHA (ADMINISTRATOR)
(601) 450-9425
Entity
Organization
Contact information
Practice address
551 EAGLE DAY AVE, COLUMBIA, MS 39429-3605
(601) 736-6137
(601) 731-1383
Mailing address
6524 U S HIGHWAY 98, HATTIESBURG, MS 39402-8569
(601) 268-9393
(601) 268-9559
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09014107
—
MS
Enumeration date
10/30/2006
Last updated
03/02/2021
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