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Organization

HATTIESBURG CLINIC PA

Active
Other names
Plastic & Reconstructive Surgery
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRYAN N BATSON MD (EXECUTIVE DIRECTOR)
(601) 264-6000
Entity
Organization

Contact information

Practice address
421 S 28TH AVE, SUITE 110, HATTIESBURG, MS 39401-7206
(601) 261-3690
(601) 261-3684
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 261-3690
(601) 261-3684

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
07202723
MS
Enumeration date
10/11/2006
Last updated
02/22/2021
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