Hattiesburg Clinic PA
Organization Active NPI Family Medicine Physician · Poplarville, MS
NPI 1720188907 · NPPES record last updated Feb 22, 2021
Key facts
- NPI
- 1720188907
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- HATTIESBURG CLINIC PA
- Practice address
- 1407 S Main St
Poplarville, MS 39470-3369 - Phone
- (601) 795-0659
- Fax
- (601) 795-8639
- NPI assigned
- Sep 25, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Bryan N Batson, MD
- Title
- Executive Director
- Phone
- (601) 264-6000
Corporate family (same tax ID) 24
National Provider Directory
- Tax ID family
- Hattiesburg Clinic PA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
1407 S Main St
Poplarville, MS 39470-3369
Mailing address
415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 579-5463
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09016107 | Medicaid | MS |
Other providers in Poplarville, MS
- Kirsten M Glass
- Grace Healthcare DME
- Helen Hannaford
- Bethany G Harrington
- Raye A Harvison
- Hattiesburg Clinic, PA
- Rhonda R Henry
- Henrietta Hicks
- Elizabeth Hoffer
- Home Medical Services
All providers in Poplarville, MS · Family Medicine 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 Feb 22, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.