Dr. Ollie Hardaway Jr. is a Vicksburg, Mississippi based Dentist who is specialized in Dentistry. He does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Dr. Ollie Hardaway Jr. is 180178 for Dentistry in Mississippi. His current practice location is 154 Cottonwood Street, Vicksburg. Patients can reach him at 662-873-4593.
Dr. Ollie Hardaway Jr. is the primary dental care provider for patients of all ages. He is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Profile:
Dr. Ollie Hardaway Jr. speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
NPI Number:
1063539138
NPI Enumeration Date:
23 Mar, 2007
NPI Last Update On:
17 Dec, 2007
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Ollie Hardaway Jr. are as mentioned below.
License Number
Specialization
State
Status
180178
Dentistry
Mississippi
Primary
180178
General Practice Dentistry
Mississippi
Secondary
Other Medical Identifiers:
Other legacy medical identifiers associated with Dr. Ollie Hardaway Jr. such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
00660200
Medicaid
Mississippi
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
113 Rialto St, Vicksburg, Mississippi
Zip:
39180-6030
Phone Number:
601-636-0834
Patients can reach Dr. Ollie Hardaway Jr. at 154 Cottonwood Street, Vicksburg, Mississippi or can call to book an appointment on 662-873-4593. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 March, 2024.