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General NPI Number Information
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NPI Number | 1841453883
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Entity Type | Organization
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Legal Business Name | W. J. MANUEL, MD, PA
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Dates
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Enumeration Date | 07/09/2008
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Last Update Date | 07/14/2008
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Provider Practice Location Address
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Address Line | 4211 HOSPITAL ST
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City | PASCAGOULA
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State | MS
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Zip | 39581-5320
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Country | US
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Telephone | 228-762-5445
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Fax | 228-762-8050
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Provider Business Mailing Address
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Address Line | 4211 HOSPITAL ST
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City | PASCAGOULA
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State | MS
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Zip | 39581-5320
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Country | US
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Telephone | 228-762-5445
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Fax | 228-762-8050
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Authorized Official
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Title or Position | OWNER/PRACTITIONER
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Name | DR. WILBERT J. MANUEL
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Credential | MD
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Telephone | 228-762-5445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 06300
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License Number State | MS
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