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David Mallory Plair

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

3700 Hardy St Ste 10, Hattiesburg, MS 39402-1553

(601) 602-2014 (601) 606-6869

PECOS Enrollment

This provider is enrolled in PECOS as DAVID PLAIR.

Based on the most recent information from CMS, provider David Mallory Plair is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1780930677
Provider Type
Individual
Full Name
Plair, David Mallory
Title
Mr.
Credential
NP

Gender
Male
Sole Proprietor
Yes
Enumeration Date
7/28/2012
Last Updated
7/28/2012

Contact Information

Practice Location

3700 Hardy St Ste 10, Hattiesburg, MS 39402-1553

(601) 602-2014

Unlisted Fax

Mailing Location

510 N 38th Ave Apt 5, Hattiesburg, MS 39401-5719

(601) 606-6869

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License R887697 Mississippi
Code 363LA2100X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License R887697 Mississippi

David Mallory Plair

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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