Organization
HATTIESBURG CLINIC PA
Active
Other names
Oak Grove Family 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
5192 OLD HIGHWAY 11, SUITE 2, HATTIESBURG, MS 39402-6222
(601) 268-0929
(601) 261-0508
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 268-0929
(601) 261-0508
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04888240
—
MS
Enumeration date
06/28/2013
Last updated
02/18/2021
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