Organization
VEIN INSTITUTE OF SOUTH MISSISSIPPI PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN KEITH THOMPSON DO (OWNER)
(601) 467-5340
Entity
Organization
Contact information
Practice address
6169 U S HIGHWAY 98, HATTIESBURG, MS 39402-8631
(601) 335-8368
Mailing address
6169 U S HIGHWAY 98, HATTIESBURG, MS 39402-8631
(601) 335-8368
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19031
MISSISSIPPI STATE BOARD OF MEDICAL LICENSURE
MS
01
—
800456806
DRIVERS LICENSE - MISSISSIPPI MOTOR VEHICLE COMMISSION
MS
Enumeration date
12/08/2021
Last updated
12/08/2021
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