Individual
ROBERT E DECOUX JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 RAWLS DR, SUITE 1300, MCCOMB, MS 39648-2877
(601) 249-3541
(601) 249-3544
Mailing address
PO BOX 511, 102 WEST FREEDOM DRIVE, LIBERTY, MS 39645-0511
(601) 657-4326
(601) 657-8867
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
07001
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00012512
—
MS
01
—
100002670
RAILROAD MEDICARE
—
01
—
1558935
AMERICAN ADMIN GROUP
MS
Enumeration date
08/03/2006
Last updated
03/01/2017
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