=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629004643
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KATE N ASEME MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/23/2006
-----------------------------------------------------
Last Update Date | 12/18/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6051 U S HIGHWAY 49
-----------------------------------------------------
City | HATTIESBURG
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39401-7200
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 601-288-2690
-----------------------------------------------------
Fax | 601-288-2695
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 16745
-----------------------------------------------------
City | HATTIESBURG
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39404-6745
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 601-288-2690
-----------------------------------------------------
Fax | 601-288-2695
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | 07913
-----------------------------------------------------
License Number State | MS
-----------------------------------------------------