Individual
MARTHA K MCMAHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
815 REBECCA AVE, HATTIESBURG, MS 39401-3930
(601) 450-4244
Mailing address
815 REBECCA AVE, HATTIESBURG, MS 39401-3930
(601) 450-4244
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00440371
—
MS
Enumeration date
02/26/2008
Last updated
02/26/2008
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