Eagle Labs 2 LLC

Primary specialty

Molecular Genetic Pathology (Pathology) PhysicianTaxonomy code 207ZP0007X

Legal business name

EAGLE LABS 2 LLC

Practice address

4 Willow PT
Hattiesburg, MS 39402-1150

Phone

(601) 898-7530

NPI assigned

Dec 9, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Katie McDonnieal

Title

Director of Operations

Phone

(601) 425-4893

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1607472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607472000000",
    "number": "1134725690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 WILLOW PT",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 WILLOW PT",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021150",
            "telephone_number": "601-898-7530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE LABS 2 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-09",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A",
        "authorized_official_last_name": "MCDONNIEAL",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "601-425-4893"
    },
    "taxonomies": [
        {
            "code": "207ZP0007X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Molecular Genetic Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Molecular Genetic Pathology (Pathology) Physician in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Molecular Genetic Pathology (Pathology) Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.