Organization
SOUTHERN WOMEN'S HEALTH, PLLC
Active
Other names
Women's Pavilion of South Mississippi
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLEY JOHNSON (ADMINISTRATOR)
(601) 450-9425
Entity
Organization
Contact information
Practice address
5003 HARDY ST, SUITE 350, HATTIESBURG, MS 39402-1319
(601) 450-9425
Mailing address
6524 U S HIGHWAY 98, HATTIESBURG, MS 39402-8569
(601) 268-9393
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05439065
—
MS
Enumeration date
06/03/2015
Last updated
12/27/2023
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