Organization
HATTIESBURG CLINIC, PA
Active
Other names
Hattiesburg Clinic Tatum Park, Tatum Park Orthopedics and Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
TOMMY G THORNTON (EXECUTIVE DIRECTOR)
(601) 264-6000
Entity
Organization
Contact information
Practice address
103 MEDICAL PARK, HATTIESBURG, MS 39401-9042
(601) 268-5757
(601) 579-5220
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-5463
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
—
—
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
06/01/2020
Last updated
06/09/2020
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