Organization
MAECENAS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERRI L HILL CHAUCE MD (PRESIDENT)
(601) 894-5110
Entity
Organization
Contact information
Practice address
206 ROBERT MCDANIEL DRIVE, HAZLEHURST, MS 39083-0146
(601) 894-5110
(601) 894-5154
Mailing address
PO BOX 146, HAZLEHURST, MS 39083-0146
(601) 894-5110
(601) 894-5154
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015686
—
MS
Enumeration date
05/30/2007
Last updated
08/22/2020
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