# HATTIESBURG CLINIC, PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Coordinated Care Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013599661
- **Authorized official:** BRYAN N BATSON MD (CEO)
- **Authorized official phone:** (601) 264-6000

## Contact information

- **Practice address:** 4209 LINCOLN RD, HATTIESBURG, MS 39402-3065
- **Practice address phone:** (601) 705-2896
- **Practice address fax:** (601) 579-5240
- **Mailing address:** 415 S 28TH AVE, HATTIESBURG, MS 39401-7246
- **Mailing address phone:** (601) 579-5463
- **Mailing address fax:** (601) 579-5240

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/23/2021
- **Last updated:** 04/23/2021