Individual
LEWIS E HATTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-5010
(601) 579-3067
Mailing address
415 SOUTH 28TH AVENUE, HATTIESBURG, MS 39401
(601) 579-5010
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
05619
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00012631
—
MS
05
—
1500747
—
LA
01
—
640507572XY
AMERICAN ADMIN GROUP
MS
Enumeration date
08/12/2006
Last updated
07/20/2020
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