Healthcare Provider Details

I. General information

NPI: 1720972029
Provider Name (Legal Business Name): LACORTIA MCFARLAND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

5317 OLD HIGHWAY 11 STE 4
HATTIESBURG MS
39402-6220
US

IV. Provider business mailing address

5317 OLD HIGHWAY 11 STE 4
HATTIESBURG MS
39402-6220
US

V. Phone/Fax

Practice location:
  • Phone: 601-381-1144
  • Fax: 601-653-0946
Mailing address:
  • Phone: 601-381-1144
  • Fax: 601-653-0946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: