Healthcare Provider Details

I. General information

NPI: 1063432383
Provider Name (Legal Business Name): NEONATAL SERVICES LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1730 14TH STREET SUITE C
MERIDIAN MS
39301
US

IV. Provider business mailing address

1730 14TH STREET SUITE C
MERIDIAN MS
39301
US

V. Phone/Fax

Practice location:
  • Phone: 601-703-9396
  • Fax:
Mailing address:
  • Phone: 601-703-9396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ROBERT D. BLUBAUGH
Title or Position: ADMINISTRATOR
Credential: D.O.
Phone: 601-703-9600