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General NPI Number Information
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NPI Number | 1326462581
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Entity Type | Organization
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Legal Business Name | BETH FELDER, MD. LLC
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Dates
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Enumeration Date | 02/08/2014
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Last Update Date | 02/08/2014
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Provider Practice Location Address
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Address Line | 118 COLLEGE DR
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City | HATTIESBURG
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State | MS
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Zip | 39406-0002
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Country | US
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Telephone | 601-266-5163
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Fax | 601-266-5850
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Provider Business Mailing Address
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Address Line | 27 DEER VLY
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City | HATTIESBURG
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State | MS
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Zip | 39402-5503
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Country | US
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Telephone | 601-264-2970
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Fax | 601-266-5850
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. ELIZABETH M FELDER
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Credential | MD
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Telephone | 601-266-5163
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT0049
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | R858140
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License Number State | MS
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 13567
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License Number State | MS
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