Provider Information for 1023764495
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LADONNA BARNER
Sex: Female
NPI: 1023764495
Last Updated: 2022-02-24
Certification Date: 2022-02-24
Certification Date: 2022-02-24
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1023764495 | ||||||||
| Enumeration Date | 2022-02-24 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 18679 HATTIESBURG, MS 39404-8679 United States Phone: 601-705-1901 | Fax:601-705-1952 | ||||||||
| Primary Practice Address | 110 PATTON AVE HATTIESBURG, MS 39401-6155 United States Phone: 601-582-1111 | Fax:601-450-0765 | ||||||||
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