Eisenhower Army Medical Center

NPI #1104031194 in Hattiesburg, Mississippi

Provider Information

NPI Number: 1104031194
Entity Type: Organization
Organization Name: Eisenhower Army Medical Center
Subpart: Yes (part of a larger organization)
Parent Organization: EISENHOWER ARMY MEDICAL CENTER
Primary Specialty: Clinic/Center - Military/U.S. Coast Guard Outpatient
Enumeration Date: May 11, 2007
Last Updated: Jan 29, 2013

Practice Location

Address: 1001 HARDY ST
City: Hattiesburg
State: Mississippi
ZIP Code: 39401-4165
Phone: (706) 787-5811

Authorized Official

Name: MARVIN PRIMOS
Title: UBO MANAGER
Phone: (706) 787-7204

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Military/U.S. Coast Guard Outpatient — Military/U.S. Coast Guard Outpatient	261QM1100X	Primary

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Eisenhower Army Medical Center Part of Eisenhower Army Medical Center	Clinic/Center - Military/U.S. Coast Guard Outpatient	Hattiesburg	AI Deep Dive
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