Provider Demographics
NPI:1679638621
Name:PETERS, WILLIAM HUGH (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HUGH
Last Name:PETERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 17708
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39404-7708
Mailing Address - Country:US
Mailing Address - Phone:601-288-3893
Mailing Address - Fax:601-288-3891
Practice Address - Street 1:6049 US HWY 49
Practice Address - Street 2:FORREST GENERAL HOSPITAL
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39404-7708
Practice Address - Country:US
Practice Address - Phone:601-264-8845
Practice Address - Fax:601-264-8845
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS07762207PE0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0013792Medicaid
MS0013792Medicaid