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NPI Code Detail

MEDICARE: QHG OF HATTIESBURG INC

MEDICARE: QHG OF HATTIESBURG INC
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
1207PE0004XEmergency Medical Services (Emergency Medicine) PhysicianMS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326032400
Entity Type Code : Organization
Provider Name (Legal Business Name) : QHG OF HATTIESBURG INC
Provider Business Mailing Address
First Line : PO BOX 689022
Second Line :
City : FRANKLIN
State : TN
Zip : 37068-9022
Country : US
Telephone Number : 615-465-7000
Fax Number : 615-465-3007
Provider Business Practice Location Address
First Line : 5001 HARDY ST
Second Line :
City : HATTIESBURG
State : MS
Zip : 39402-1308
Country : US
Telephone Number : 601-268-8000
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : DEBBIE BREWER
Credential :
Telephone Number : 877-892-9813
Provider Enumeration Date : 09/06/2005
Last Update Date : 06/01/2012

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