Organization
PAUL MATHERNE, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL G. MATHERNE M.D. (OWNER/SOLO)
(228) 388-4862
Entity
Organization
Contact information
Practice address
180B DEBUYS RD, SUITE #223, BILOXI, MS 39531-4404
(228) 388-4862
(228) 388-2556
Mailing address
180B DEBUYS RD, SUITE #223, BILOXI, MS 39531-4404
(228) 388-4862
(228) 388-2556
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
09445
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000018917
—
MS
01
—
437709303
BCBS OF MS/ BCBS OF ALA.
MS
Enumeration date
09/20/2006
Last updated
12/08/2015
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