Organization
MS PAIN & MIGRAINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATIE MCDONNIEAL (DIRECTOR OF OPERATIONS)
(601) 425-4893
Entity
Organization
Contact information
Practice address
4 WILLOW PT, HATTIESBURG, MS 39402-1150
(601) 898-7530
Mailing address
4 WILLOW PT, HATTIESBURG, MS 39402-1150
Taxonomy
Speciality
Code
Description
License number
State
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
Primary
—
—
Other
Enumeration date
12/09/2020
Last updated
04/13/2021
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