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Individual

DR. RONALD C MOZINGO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
6096 US HWY 98, SUITE 1A, HATTIESBURG, MS 39402
(601) 261-2467
(601) 296-6685
Mailing address
6096 US HWY 98, SUITE 1A, HATTIESBURG, MS 39402
(601) 261-2467
(601) 296-6685

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
470
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00087886
MS
01
P00037724
PALMETTO GBA RR MEDICARE
MS
Enumeration date
11/17/2006
Last updated
07/08/2007
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