Organization
LAUREL UROLOGY CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HORACE C WATKINS III MD (PRESIDENT)
(601) 428-0438
Entity
Organization
Contact information
Practice address
304 S 10TH AVE, LAUREL, MS 39440
(601) 428-0438
(601) 425-5553
Mailing address
PO BOX 2728, LAUREL, MS 39442-2728
(601) 428-0438
(601) 425-5553
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
05031
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09011830
—
MS
Enumeration date
07/23/2007
Last updated
07/23/2007
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