Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Pine Belt Dermatopathology Lab, PA

Organization Dermatopathology Physician · NPI 1366269748

Pine Belt Dermatopathology Lab, PA provides Dermatopathology Physician services in Petal, Mississippi. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

103 Ford Dr
Petal, MS 39465-2801
Phone: (601) 475-9968
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatopathology Physician (primary) Taxonomy 207ND0900X

Record details

NPI number1366269748
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official David Roy — Doctor/Owner · (601) 475-9968
NPI enumeratedSeptember 25, 2024
Last updated in NPPESSeptember 25, 2024
Certification dateSeptember 25, 2024
Mailing address102 E Hospital Dr, Hattiesburg, MS 39402-1310