Basic Information
Provider Information
NPI: 1992729172
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARNETT
FirstName: WILLIAM
MiddleName: R
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 415 S 28TH AVE
Address2:  
City: HATTIESBURG
State: MS
PostalCode: 394017246
CountryCode: US
TelephoneNumber: 6015793300
FaxNumber: 6015795240
Practice Location
Address1: 415 S 28TH AVE
Address2:  
City: HATTIESBURG
State: MS
PostalCode: 394017246
CountryCode: US
TelephoneNumber: 6012685610
FaxNumber: 6012613521
Other Information
ProviderEnumerationDate: 07/27/2006
LastUpdateDate: 08/23/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X07278MSY Allopathic & Osteopathic PhysiciansFamily Medicine 

ID Information
IDTypeStateIssuerDescription
0001677605MS MEDICAID
155891801MSAMERICAN ADMIN GROUPOTHER
08294553401MSRAILROAD MEDICAREOTHER


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