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General NPI Number Information
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NPI Number | 1609121557
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Entity Type | Organization
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Legal Business Name | USA PATHOLOGY PLLC
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Dates
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Enumeration Date | 07/17/2012
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Last Update Date | 07/20/2012
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Provider Practice Location Address
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Address Line | 5052 W 4TH ST STE 3
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City | HATTIESBURG
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State | MS
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Zip | 39402-1069
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Country | US
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Telephone | 601-261-2587
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Fax |
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Provider Business Mailing Address
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Address Line | 5052 W 4TH ST STE 3
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City | HATTIESBURG
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State | MS
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Zip | 39402-1069
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Country | US
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Telephone | 601-261-2587
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Fax |
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Authorized Official
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Title or Position | SOLE MBR
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Name | KURT KRATZ
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Credential | M.D.
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Telephone | 601-261-2587
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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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