NPIMap

Organization Active NPI

Hattiesburg Clinic PA

Doing business as Hattiesburg Clinic Dermatology

  • Dermatology Physician
  • Hattiesburg, MS
National Provider Identifier
1114014479
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
HATTIESBURG CLINIC PA
Doing business as
Hattiesburg Clinic Dermatology
Practice address
6 Medical Blvd
Hattiesburg, MS 39401-7230
Phone
(601) 264-8433
Fax
(601) 264-8800
NPI assigned
Oct 6, 2006
Last updated
Oct 7, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Authorized official

Name
Dr. Bryan N Batson, MD
Title
Executive Director
Phone
(601) 268-5601

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

6 Medical Blvd
Hattiesburg, MS 39401-7230

Mailing address

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 264-8433

Other names 1

  • Hattiesburg Clinic Dermatology Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Hattiesburg Clinic PA136 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 23

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602028800000",
    "number": "1114014479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-264-8433",
            "fax_number": "601-264-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 MEDICAL BLVD",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017230",
            "telephone_number": "601-264-8433",
            "fax_number": "601-264-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HATTIESBURG CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A",
        "authorized_official_last_name": "BATSON",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "601-268-5601",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hattiesburg Clinic Dermatology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hattiesburg Clinic Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hattiesburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.