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NPI Code Detail

MEDICARE: DR. ROBERT EUGENE EVERETT JR.

MEDICARE:  DR. ROBERT EUGENE EVERETT JR.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist3037-98MS

General Provider Information

NPI Number : 1003905381
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT EUGENE EVERETT JR.
Provider Business Mailing Address
First Line : 2693 BIENVILLE BLVD
Second Line :
City : OCEAN SPRINGS
State : MS
Zip : 39564-3106
Country : US
Telephone Number : 228-872-2000
Fax Number :
Provider Business Practice Location Address
First Line : 2693 BIENVILLE BLVD
Second Line :
City : OCEAN SPRINGS
State : MS
Zip : 39564-3106
Country : US
Telephone Number : 228-872-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2006
Last Update Date : 07/08/2007

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Directions to “ DR. ROBERT EUGENE EVERETT JR. ” Practice Location

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