Organization
HATTIESBURG CLINIC PA
Active
Other names
Radiology
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) 268-5707
(601) 268-5813
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 526-4600
(601) 268-5813
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
—
—
2085N0700X
Neuroradiology Physician
—
—
2085N0904X
Nuclear Radiology Physician
—
—
2085P0229X
Pediatric Radiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00503777
—
MS
Enumeration date
11/09/2006
Last updated
10/07/2020
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