Lauderdale, Rebecca Walters

Lauderdale, Rebecca Walters is an individual health care provider with primary practice located at 1101 S 28Th Ave Ste D , Hattiesburg MS 39402-2610. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Lauderdale, Rebecca Walters can be contacted via phone (601) 296-2980.

Contact Information

Primary practice address
1101 S 28Th Ave Ste D Hattiesburg MS 39402-2610
Phone: (601) 296-2980
Fax: (601) 296-2975
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 19683 Mississippi

Profile Details

NPI number 1275664732
LBN Legal business name Lauderdale, Rebecca Walters
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 8th, 2007
Last updated Jul 22nd, 2020 - about 4 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 1275664732 NPPES
Mississippi MEDICAID 01224050
Mississippi Other 9445059

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