Individual
DR. CHARLES ERICKSON PROBST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2313 HIGHWAY 15 N, LAUREL, MS 39440-1805
(601) 649-2775
(601) 579-5240
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 649-2775
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20941
MS
207Q00000X
Family Medicine Physician
DO1073
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07689072
—
MS
Enumeration date
06/24/2010
Last updated
08/11/2020
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