Organization
HATTIESBURG CLINIC PA
Active
Other names
Ambulatory Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN N BATSON MD (EXECUTIVE DIRECTOR)
(601) 268-5601
Entity
Organization
Contact information
Practice address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-5075
(601) 579-5039
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-5488
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00770554
—
MS
05
—
1503916
—
LA
Enumeration date
07/21/2006
Last updated
10/07/2020
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