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General NPI Number Information
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NPI Number | 1417545922
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Entity Type | Organization
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Legal Business Name | FORREST GENERAL HOSPITAL
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Dates
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Enumeration Date | 01/10/2021
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Last Update Date | 01/13/2021
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Provider Practice Location Address
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Address Line | 415 S 28TH AVE
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City | HATTIESBURG
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State | MS
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Zip | 39401-7283
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Country | US
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Telephone | 601-264-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 6051 U S HIGHWAY 49
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City | HATTIESBURG
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State | MS
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Zip | 39401-7200
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Country | US
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Telephone | 601-288-7000
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Fax |
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Authorized Official
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Title or Position | SPECIALIST TECHNOLOGIST
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Name | PROF. JACOB CORNELIUS PARKER
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Credential | DO MD PHD
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Telephone | 601-264-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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