Organization
HATTIESBURG CLINIC, P.A.
Active
Organization
HATTIESBURG CLINIC, P.A.
Active
Other names
Pachuta Dialysis Unit
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN N BATSON MD (EXECTIVE DIRECTOR)
(601) 268-5601
Entity
Organization
Contact information
Practice address
180 EAST MAIN STREET, PACHUTA, MS 39347
(601) 296-2902
(601) 296-2961
Mailing address
5909 HIGHWAY 49, SUITE 10, HATTIESBURG, MS 39402-2860
(601) 296-2902
(601) 296-2961
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09856336
—
MS
Enumeration date
10/04/2007
Last updated
06/14/2023
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