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General NPI Number Information
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NPI Number | 1255529228
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Entity Type | Organization
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Legal Business Name | HATTIESBURG CLINIC, P.A.
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Dates
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Enumeration Date | 10/04/2007
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Last Update Date | 06/14/2023
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Provider Practice Location Address
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Address Line | 180 EAST MAIN STREET
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City | PACHUTA
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State | MS
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Zip | 39347
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Country | US
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Telephone | 601-296-2902
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Fax | 601-296-2961
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Provider Business Mailing Address
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Address Line | 5909 HIGHWAY 49 SUITE 10
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City | HATTIESBURG
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State | MS
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Zip | 39402-2860
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Country | US
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Telephone | 601-296-2902
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Fax | 601-296-2961
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Authorized Official
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Title or Position | EXECTIVE DIRECTOR
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Name | DR. BRYAN N BATSON
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Credential | MD
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Telephone | 601-268-5601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State |
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