Hal T Liddell, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

09147 Issued in MS

Practice address

139 Fairfield Dr
Hattiesburg, MS 39402-1303

Phone

(601) 450-2401

Fax

(601) 450-2433

NPI assigned

Jul 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Urology

Education

University of Mississippi School of Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Urology, P. a.Group PAC ID 0042287575, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Merit Health Wesley Hospital, Hattiesburg, MS, CCN 250094
• Forrest General Hospital Hospital, Hattiesburg, MS, CCN 250078
• South Central Reg Med Ctr Hospital, Laurel, MS, CCN 250058

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: southernsurgicalassociatespa.halliddell@150945.advancedmd-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southern Urology, P. a.

  • Specialist
  • Hattiesburg, MS
  • NPI 1316065436
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Forrest County General Hospital

  • General Acute Care Hospital
  • Hattiesburg, MS
  • NPI 1225041809
  Care Compare affiliation
• South Central Regional Medical Center

  • General Acute Care Hospital
  • Laurel, MS
  • NPI 1619973542
  Care Compare affiliation
• Wesley Health System LLC

  • General Acute Care Hospital
  • Hattiesburg, MS
  • NPI 1841241841
  Care Compare affiliation

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1023032497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 FAIRFIELD DR",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021303",
            "telephone_number": "601-450-2401",
            "fax_number": "601-450-2434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 FAIRFIELD DR",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021303",
            "telephone_number": "601-450-2401",
            "fax_number": "601-450-2433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIDDELL",
        "first_name": "HAL",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MS",
            "license": "09147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023032497",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "509218YTSR",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gary L Lett, D.C.
• Adam Lewis
• Nancy Danielle Lewis, DPT
• Ramona Ann Lewis, PHARMACIST
• Timothy Lewis, CRNA
• Thompson Worth Liddell, M.D.
• Lifecycle Nutrition Services LLC
• Lilly Pad Home Health, LLC
• Lilly Pad Home Health, LLC
• Andrew C Lin, MD

• Urology Physician in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Urology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.