Organization
DIGESTIVE DISEASES CENTER OF HATTIESBURG, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN E BUCKLEY M.D. (MEDICAL DIRECTOR)
(601) 268-5189
Entity
Organization
Contact information
Practice address
1000 TURTLE CREEK DR STE 4, HATTIESBURG, MS 39402-1173
(601) 268-5189
(601) 268-5006
Mailing address
100 METHODIST HOSPITAL BLVD, HATTIESBURG, MS 39402-1295
(601) 268-5189
(601) 268-5006
Taxonomy
Speciality
Code
Description
License number
State
261QE0800X
Endoscopy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02358833
—
MS
01
—
P00138452
RAILROAD MEDICARE
MS
Enumeration date
08/19/2006
Last updated
01/23/2023
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