# HATTIESBURG ANESTHESIA ASSOCIATES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265564041
- **Authorized official:** KENNETH RAYNOR ELLINGTON MD (PRESIDENT)
- **Authorized official phone:** (864) 591-1540

## Contact information

- **Practice address:** 5001 HARDY ST, HATTIESBURG, MS 39402-1308
- **Practice address phone:** (601) 268-8000
- **Mailing address:** 158 W MAIN ST, SPARTANBURG, SC 29306-2333
- **Mailing address phone:** (864) 591-1540
- **Mailing address fax:** (864) 591-1455

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/09/2007
- **Last updated:** 08/22/2020