Individual
KEITH M SIMNICHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
102 MEDICAL PARK, HATTIESBURG, MS 39401-9080
(601) 261-5159
(601) 545-1740
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 544-7404
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14595
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00113836
—
MS
01
—
640507572AZ
AMERICAN ADMIN GROUP
MS
Enumeration date
08/29/2006
Last updated
06/12/2025
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