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General NPI Number Information
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NPI Number | 1548928443
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Entity Type | Organization
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Legal Business Name | VEIN INSTITUTE OF SOUTH MISSISSIPPI PLLC
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Dates
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Enumeration Date | 12/08/2021
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Last Update Date | 12/08/2021
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Provider Practice Location Address
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Address Line | 6169 U S HIGHWAY 98
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City | HATTIESBURG
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State | MS
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Zip | 39402-8631
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Country | US
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Telephone | 601-335-8368
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Fax |
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Provider Business Mailing Address
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Address Line | 6169 U S HIGHWAY 98
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City | HATTIESBURG
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State | MS
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Zip | 39402-8631
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Country | US
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Telephone | 601-335-8368
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOHN KEITH THOMPSON
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Credential | DO
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Telephone | 601-467-5340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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