Individual
DECLAN F HEGARTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
57 DEWEY ST, LUCEDALE, MS 39452-5707
(601) 766-0308
(601) 766-0309
Mailing address
PO BOX 1007, LUCEDALE, MS 39452-1007
(601) 766-0308
(601) 766-0309
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
25465
MS
208600000X
Surgery Physician
ME94859
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1477526945
NPI
FL
01
—
25465
MS MEDICAL LICENSURE
MS
05
—
277709600
—
FL
Enumeration date
02/07/2006
Last updated
03/17/2018
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