{
"Npi": {
"NPI": "1255529228",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HATTIESBURG CLINIC, P.A.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "5909 HIGHWAY 49",
"SecondLineMailingAddress": "SUITE 10",
"MailingAddressCityName": "HATTIESBURG",
"MailingAddressStateName": "MS",
"MailingAddressPostalCode": "39402-2860",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "601-296-2902",
"MailingAddressFaxNumber": "601-296-2961",
"FirstLinePracticeLocationAddress": "180 EAST MAIN STREET",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PACHUTA",
"PracticeLocationAddressStateName": "MS",
"PracticeLocationAddressPostalCode": "39347",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "601-296-2902",
"PracticeLocationAddressFaxNumber": "601-296-2961",
"EnumerationDate": "10/04/2007",
"LastUpdateDate": "06/14/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BATSON",
"AuthorizedOfficialFirstName": "BRYAN",
"AuthorizedOfficialMiddleName": "N",
"AuthorizedOfficialTitle": "EXECTIVE DIRECTOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "601-268-5601",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QE0700X",
"TaxonomyName": "End-Stage Renal Disease (ESRD) Treatment Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}