David B Roy DO PA
Organization Active NPI MOHS-Micrographic Surgery Physician · Petal, MS
NPI 1194124834 · NPPES record last updated Jun 11, 2025
Key facts
- NPI
- 1194124834
- Entity type
- Organization (NPI type 2)
- Primary specialty
- MOHS-Micrographic Surgery Physician 207ND0101X
- License
- 21178 (MS)
- Legal business name
- DAVID B ROY DO PA
- Practice address
- 201 S Main St
Petal, MS 39465-2362 - Phone
- (318) 884-9706
- NPI assigned
- Aug 19, 2014
- Organization subpart
- No
Authorized official
- Name
- David Bernard Roy, D.O.
- Title
- Doctor
- Phone
- (601) 475-9968
Practitioners 17
-
David Bernard Roy, D.O.
-
Marisa D Stringer, NP-C
-
Eugene Conte, DO
-
Lauren Ackerman, PA
-
Lauren S Aycock, FNP
-
Hannah Long Price, PA-C
-
Kristen Richardson, P.A.-C
-
Eric Carl Torp, M.D.
-
Lisa Renee Chastant, M.D.
-
Marianna M Helin, NP
-
Brooke Nitz, PA-C
-
Tammy Nicole Reus, MSN, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150219000500 | MS | Part B Supplier - Clinic/Group Practice | 2365767118 |
Receives reassigned benefits from 14 practitioners Practice locations: Hattiesburg, MS; Petal, MS |
National Provider Directory
Locations
1009 Tommy Munro Dr
#A
Biloxi, MS 39532
Phone (228) 232-0872
1244 Highway 29 N
Ellisville, MS 39437
Phone (601) 261-5771
102 E Hospital Dr
Hattiesburg, MS 39402
Phone (601) 268-5144
103 Ford Dr
#B
Petal, MS 39465
Phone (601) 336-5626
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| MOHS-Micrographic Surgery Physician |
207ND0101X | 21178 | MS | Yes |
Addresses
Primary practice location
201 S Main St
Petal, MS 39465-2362
Mailing address
102 E Hospital Dr
Hattiesburg, MS 39402-1310
Phone (601) 475-9968
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09537875 | Medicaid | MS | |
| 1194124834 | Other | MS | GROUP NPI |
| 595626050 | Other | MS | BC/BS OF MS |
Other names
- Pine Belt Dermatology & Skin Cancer Center
Other providers in Petal, MS
- Core Nutrition Health and Wellness, LLC
- Frances Counts
- Jacy Csaszar
- Martha D'Ilio
- Victor D'Ilio
- Dominion Health Services, LLC
- Guy L Doty Jr.
- Dr Michael S. Zaleski
- Drayer Physcial Therapy Mississippi LLC
- Drayer Physical Therapy Institute LLC
All providers in Petal, MS · MOHS-Micrographic Surgery Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.