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Randy S. Hathorn D.m.d

Randy S. Hathorn D.m.d is a health care provider in Bassfield, MS. In this page you will find its mailing address, practice location, phone number, specialty etc.

physician-icon Basic Information

Practice Location 218 Gen Robert E Blount, A, Bassfield, MS 39421-0549, US
Practice Location Phone601-943-5126
Practice Location Fax601-943-6143
Legal Business NameRANDY S. HATHORN D.M.D
NPI ?1528242351
Entity TypeOrganization
Enumeration Date ? Dec 28, 2007
Last Update Date ? Dec 28, 2007
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of Randy S. Hathorn D.m.d

SpecialtySpecializationLicenseLicense State
Dentist 2016-83Mississippi
Dentist 3361-05Mississippi

legacy-id-icon Legacy Provider IDs of Randy S. Hathorn D.m.d

Provider IdIssuer StateIssuer TypeIssuer

official-icon Authorized Official of Randy S. Hathorn D.m.d

An authorized official is an appointed official with the legal authority to make changes and/or updates to the Randy S. Hathorn D.m.d's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).

Authorized Official Randy S Hathorn (D.M.D.)
Authorized Official Title/PositionOWNER
Authorized Official Phone Number601-943-5126