Individual
PETER L. HERCULES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
427 HWY 51 NORTH, BROOKHAVEN, MS 39601-2600
(601) 892-2149
Mailing address
200 CORPORATE BLVD., SUITE 201, LAFAYETTE, LA 70508
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
16013
MS
207P00000X
Emergency Medicine Physician
293334
NY
207Q00000X
Family Medicine Physician
293334
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00126873
—
MS
Enumeration date
06/13/2006
Last updated
04/05/2018
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