Oak Grove High School

Specialty details in registry · Hattiesburg, MS

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At a glance

5198 Old Highway 11, Hattiesburg, MS 39402-6222

NPPES record updated Feb 5, 2026. Public records can lag behind changes at a practice.

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Insurance participation and appointment availability are not established by these public records.

Practice location

5198 Old Highway 11
Hattiesburg, MS 39402-6222
Professional details: NPI, taxonomy & registry record
NPI1790359966
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Registry details

Primary taxonomy
Specialty details in registry
Taxonomy code
261QF0400X
Enumeration date
May 13, 2021
Record updated
Feb 5, 2026
More registry details
Provider type
Organization · Type 2
Other reported name
<UNAVAIL>

Reported taxonomies and licenses

Specialty details in registry

261QF0400X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

5198 Old Highway 11
Hattiesburg, MS 39402-6222
Phone
(601) 264-7232
Fax
(601) 796-9437
Mailing address
PO BOX 1729

HATTIESBURG, MS 394031729
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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