Organization
PETAL MIDDLE SCHOOL
Active
Other names
Petal Middle School
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE ROBINSON CEO (CHIEF EXECUTIVE OFFICEER)
(601) 545-8700
Entity
Organization
Contact information
Practice address
203 HIGHWAY 42, PETAL, MS 39465-2864
(601) 584-6301
(601) 450-2493
Mailing address
PO BOX 1729, HATTIESBURG, MS 39403-1729
(601) 545-8700
(601) 450-2493
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007528765
—
MS
05
—
07528765
—
MS
01
—
251012
MS MEDICARE PTAN
MS
Enumeration date
02/07/2013
Last updated
02/05/2026
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