Healthcare Provider Details

I. General information

NPI: 1619008174
Provider Name (Legal Business Name): FORREST COUNTY GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 12/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 COUNTRY CLUB RD
CARRIERE MS
39426
US

IV. Provider business mailing address

PO BOX 15722
HATTIESBURG MS
39404-5722
US

V. Phone/Fax

Practice location:
  • Phone: 601-799-4777
  • Fax: 601-799-0052
Mailing address:
  • Phone: 601-288-1823
  • Fax: 601-288-1877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID PYLATE
Title or Position: PATIENT ACCOUNTS MANAGER
Credential:
Phone: 601-288-1864