Latack, Wayne Arthur
Latack, Wayne Arthur is an individual health care provider with primary practice located at 301 Fisher St Keesler Afb, Biloxi MS 39534-2508. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Nephrology. Allopathic & Osteopathic Physicians / Nephrology is his primary health care specialty. Latack, Wayne Arthur can be contacted via phone (228) 376-3372.Contact Information
Primary practice address
301 Fisher St Keesler Afb
Biloxi MS 39534-2508
Phone: (228) 376-3372
Fax: (228) 376-0125
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 21859 | Mississippi |
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 21859 | Mississippi |
Profile Details
| NPI number | 1629288089 |
|---|---|
| LBN Legal business name | Latack, Wayne Arthur |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 23rd, 2007 |
| Last updated | Oct 12th, 2023 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629288089 | NPPES |
| Mississippi | Other | 21859 | MEDICAL LICENSURE |
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