Healthcare Provider Details

I. General information

NPI: 1922574425
Provider Name (Legal Business Name): FORREST COUNTY GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2018
Last Update Date: 04/24/2020
Certification Date: 04/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 HIGHLAND PKWY
PICAYUNE MS
39466-5575
US

IV. Provider business mailing address

125 S 28TH AVE STE 326
HATTIESBURG MS
39401-7152
US

V. Phone/Fax

Practice location:
  • Phone: 601-358-9765
  • Fax: 601-358-9929
Mailing address:
  • Phone:
  • Fax: 601-288-4360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. BEN HESTER
Title or Position: CFO
Credential:
Phone: 601-288-4225