Organization
HATTIESBURG CLINIC PA
Active
Other names
Purvis Family Practice Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN N BATSON MD (EXECUTIVE DIRECTOR)
(601) 264-6000
Entity
Organization
Contact information
Practice address
102 SHELBY SPEIGHTS DR, PURVIS, MS 39475-4151
(601) 794-8065
(601) 794-5650
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-5463
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09013970
—
MS
05
—
1527661
—
LA
Enumeration date
09/25/2006
Last updated
02/18/2021
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