| Dr Hal T Liddell, MD | |
|
139 Fairfield Dr, Hattiesburg, MS 39402-1303 | |
| (601) 450-2401 | |
| (601) 450-2433 |
| Full Name | Dr Hal T Liddell |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 46 Years |
| Location | 139 Fairfield Dr, Hattiesburg, Mississippi |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023032497 | NPI | - | NPPES |
| 1023032497 | Medicaid | MS | |
| 509218YTSR | Other | MS | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 09147 (Mississippi) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Merit Health Wesley | Hattiesburg, MS | Hospital |
| Forrest General Hospital | Hattiesburg, MS | Hospital |
| South Central Reg Med Ctr | Laurel, MS | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Southern Urology, P. A. | 0042287575 | 4 |
| Entity Name | Southern Urology, P. A. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1316065436 PECOS PAC ID: 0042287575 Enrollment ID: O20110405000769 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Hal T Liddell, MD 139 Fairfield Dr, Hattiesburg, MS 39402-1303 Ph: (601) 450-2401 | Dr Hal T Liddell, MD 139 Fairfield Dr, Hattiesburg, MS 39402-1303 Ph: (601) 450-2401 |
John Moore, Urology Medicare: Accepting Medicare Assignments Practice Location: 415 S 28th Ave, Hattiesburg, MS 39401 Phone: 601-268-5888 Fax: 601-261-3587 | |
Sean Philip Douglas, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 415 S 28th Ave, Hattiesburg, MS 39401 Phone: 601-268-5888 Fax: 601-579-5240 | |
Dr. Nathan P Shappley, M.D. Urology Medicare: Medicare Enrolled Practice Location: 101 Aldersgate Cir, Hattiesburg, MS 39402 Phone: 601-261-5800 Fax: 601-261-5813 | |
Bradley N Secrest, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 415 S 28th Ave, Hattiesburg, MS 39401 Phone: 601-268-5888 Fax: 601-261-3587 | |
Woodie J Wilson Jr., MD Urology Medicare: Accepting Medicare Assignments Practice Location: 415 S 28th Ave, Hattiesburg, MS 39401 Phone: 601-268-5888 Fax: 601-261-3587 | |
David C Stout, MD Urology Medicare: Not Enrolled in Medicare Practice Location: 4 Pebble Crk, Hattiesburg, MS 39402 Phone: 601-261-9323 |