=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326995283
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NATELADNER LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/11/2026
-----------------------------------------------------
Last Update Date | 03/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 20274 SAUCIER LIZANA RD
-----------------------------------------------------
City | SAUCIER
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39574-8683
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 228-263-1178
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 20274 SAUCIER LIZANA RD
-----------------------------------------------------
City | SAUCIER
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39574-8683
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 228-263-1178
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | NATHAN ROY LADNER
-----------------------------------------------------
Credential | SA-C
-----------------------------------------------------
Telephone | 228-263-1178
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 246ZC0007X
-----------------------------------------------------
Taxonomy Name | Surgical Assistant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------