Mallett, Tara S.

Mallett, Tara S. is an individual health care provider with primary practice located at 92 W. Ratliff Street , Lucedale MS 39452-6537. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Mallett, Tara S. can be contacted via phone (601) 947-8181.

Contact Information

Primary practice address
92 W. Ratliff Street Lucedale MS 39452-6537
Phone: (601) 947-8181
Fax: (601) 947-4411
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 13329 Mississippi

Profile Details

NPI number 1467565267
LBN Legal business name Mallett, Tara S.
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 16th, 2006
Last updated Jan 6th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467565267 NPPES
Mississippi MEDICAID 0112990

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