Individual
CORNELIUS E. REGAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
109 MILLSAPS DR STE B, HATTIESBURG, MS 39402-1587
(601) 255-0736
Mailing address
109 MILLSAPS DR STE B, HATTIESBURG, MS 39402-1587
(601) 255-0736
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
60893
TN
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
27509
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000559073
—
MS
Enumeration date
04/08/2016
Last updated
12/28/2022
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