Douglas, Laurie Evans

Douglas, Laurie Evans is an sole proprietor health care provider with primary practice located at 301 S 28Th Ave , Hattiesburg MS 39401-7233. She recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as her primary health care specialty. Douglas, Laurie Evans can be contacted via phone (601) 261-1700.

Contact Information

Primary practice address
301 S 28Th Ave Hattiesburg MS 39401-7233
Phone: (601) 261-1700
Fax: (601) 288-8290
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 23948 Mississippi

Profile Details

NPI number 1013173590
LBN Legal business name Douglas, Laurie Evans
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 4th, 2008
Last updated Jul 9th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013173590 NPPES
Mississippi MEDICAID 00324314
Mississippi Other 10131735900
Mississippi MEDICAID 10131735900
Mississippi Other 187RG
Mississippi Other 10131735900
Mississippi Other Q94015

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