NPIMap

Organization Active NPI

Spine Medical Center of Hattiesburg

  • Neurological Surgery Physician
  • Hattiesburg, MS
National Provider Identifier
1982824579
Registry record updated Jul 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
14446 Issued in MS
Legal business name
SPINE MEDICAL CENTER OF HATTIESBURG
Practice address
1 Lincoln Pkwy
Suite 104
Hattiesburg, MS 39402-3262
Phone
(601) 264-9448
Fax
(601) 264-9449
NPI assigned
Apr 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2008

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

Authorized official

Name
Dr. Davide Clark Lee, M.D.
Title
Dr.
Phone
(601) 264-9448

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X 14446 MS Primary

Addresses

Primary practice location

1 Lincoln Pkwy
Suite 104
Hattiesburg, MS 39402-3262

Mailing address

PO Box 2156
Gulfport, MS 39505-2156
Phone (228) 865-4731

National Provider Directory

National Provider Directory

Locations

1 Lincoln Pkwy
Ste 104
Hattiesburg, MS 39402
Phone (601) 264-9448

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1982824579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2156",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395052156",
            "telephone_number": "228-865-4731",
            "fax_number": "228-863-5616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LINCOLN PKWY",
            "address_2": "SUITE 104",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394023262",
            "telephone_number": "601-264-9448",
            "fax_number": "601-264-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE MEDICAL CENTER OF HATTIESBURG",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "DAVIDE",
        "authorized_official_middle_name": "CLARK",
        "authorized_official_title_or_position": "DR.",
        "authorized_official_telephone_number": "601-264-9448",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "MS",
            "license": "14446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 2, 2008; 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.