Organization
FORREST GENERAL HOSPITAL
Active
Organization
FORREST GENERAL HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PROF. JACOB CORNELIUS PARKER DO MD PHD (SPECIALIST TECHNOLOGIST)
(601) 264-6000
Entity
Organization
Contact information
Practice address
415 S 28TH AVE, HATTIESBURG, MS 39401-7283
(601) 264-6000
Mailing address
6051 U S HIGHWAY 49, HATTIESBURG, MS 39401-7200
(601) 288-7000
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
—
—
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
84-2004221-3
ZOHO HEALTHCARE PROVIDER
VA
Enumeration date
01/10/2021
Last updated
01/13/2021
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