Healthcare Provider Details

I. General information

NPI: 1326178039
Provider Name (Legal Business Name): WESLEY HEALTH SYSTEM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 METHODIST BLVD
HATTIESBURG MS
39402
US

IV. Provider business mailing address

239 METHODIST BLVD
HATTIESBURG MS
39402
US

V. Phone/Fax

Practice location:
  • Phone: 601-268-5026
  • Fax: 601-268-8645
Mailing address:
  • Phone: 601-268-5026
  • Fax: 601-268-8645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1216B
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC0376
License Number StateMS

VIII. Authorized Official

Name: RON T SEAL
Title or Position: CEO
Credential:
Phone: 601-268-8101