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General NPI Number Information
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NPI Number | 1578691499
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Entity Type | Organization
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Legal Business Name | SOUTHERN MISSISSIPPI NEONATOLOGY, PA
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 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 | 601-288-3440
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Fax | 601-288-3451
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Provider Business Mailing Address
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Address Line | 1108 OAKLEIGH DR
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City | HATTIESBURG
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State | MS
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Zip | 39402-3068
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Country | US
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Telephone | 601-288-3440
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Fax | 601-288-3451
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CLINTON B WHITE
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Credential | M.D.
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Telephone | 601-288-3440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number |
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License Number State |
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