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General NPI Number Information
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NPI Number | 1477601177
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Entity Type | Organization
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Legal Business Name | FORREST COUNTY GENERAL HOSPITAL
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 300 S 29TH AVE
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City | HATTIESBURG
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State | MS
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Zip | 39401-7127
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Country | US
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Telephone | 601-288-1050
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Fax |
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Provider Business Mailing Address
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Address Line | 300 S 29TH AVE
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City | HATTIESBURG
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State | MS
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Zip | 39401-7127
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Country | US
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Telephone | 601-288-1050
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Fax |
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Authorized Official
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Title or Position | CEO PRESIDENT
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Name | MR. WILLIAM C OLIVIER
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Credential |
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Telephone | 601-288-1050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number |
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License Number State |
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