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General NPI Number Information
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NPI Number | 1831687953
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Entity Type | Organization
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Legal Business Name | E KEVIN OHEA MD GENERAL FAMILY PRACTICE LLC
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Dates
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Enumeration Date | 04/24/2018
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Last Update Date | 04/24/2018
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Provider Practice Location Address
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Address Line | 697 MANILA ST
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City | LUCEDALE
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State | MS
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Zip | 39452-6505
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Country | US
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Telephone | 601-947-3377
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Fax | 601-947-3380
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Provider Business Mailing Address
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Address Line | 697 MANILA ST
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City | LUCEDALE
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State | MS
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Zip | 39452-6505
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Country | US
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Telephone | 601-947-3377
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Fax | 601-947-3380
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Authorized Official
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Title or Position | MBR
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Name | DR. E KEVIN O'HEA
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Credential | MD
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Telephone | 601-947-3377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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