Healthcare Provider Details

I. General information

NPI: 1699295972
Provider Name (Legal Business Name): JAROT J GUERRA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JAROT J GUERRA EDER MD

II. Dates (important events)

Enumeration Date: 06/27/2017
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 S 28TH AVE
HATTIESBURG MS
39401-7246
US

IV. Provider business mailing address

415 S 28TH AVE
HATTIESBURG MS
39401-7246
US

V. Phone/Fax

Practice location:
  • Phone: 601-268-5800
  • Fax:
Mailing address:
  • Phone: 601-258-0068
  • Fax: 713-486-6728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number36718
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: