Organization
OAK GROVE LONGLEAF
Active
Other names
Oak Grove Longleaf
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE ROBINSON (CEO)
(601) 545-8700
Entity
Organization
Contact information
Practice address
5279 W 4TH ST, HATTIESBURG, MS 39402-9700
(601) 264-3858
(601) 450-2493
Mailing address
PO BOX 1729, HATTIESBURG, MS 39403-1729
(601) 545-8700
(601) 450-2493
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200002175
—
MS
Enumeration date
05/13/2021
Last updated
02/05/2026
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