Organization
HATTIESBURG CLINIC, PA
Active
Other names
Lincoln Road Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN N BATSON MD (EXECUTIVE DIRECTOR)
(601) 264-6000
Entity
Organization
Contact information
Practice address
4209 LINCOLN ROAD, HATTIESBURG, MS 39402
(601) 579-5400
(601) 261-3521
Mailing address
4209 LINCOLN ROAD FAMILY MEDICINE, HATTIESBURG, MS 39402
(601) 579-5400
(601) 261-3521
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11345
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09014185
—
MS
Enumeration date
09/08/2011
Last updated
02/18/2021
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