Organization
PINE BELT DERMATOPATHOLOGY LAB, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID ROY DO (DOCTOR/OWNER)
(601) 475-9968
Entity
Organization
Contact information
Practice address
103 FORD DR, PETAL, MS 39465-2801
(601) 475-9968
Mailing address
102 E HOSPITAL DR, HATTIESBURG, MS 39402-1310
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary
—
—
Other
Enumeration date
09/25/2024
Last updated
09/25/2024
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