Organization
HATTIESBURG CLINIC, PA
Active
Organization
HATTIESBURG CLINIC, PA
Active
Other names
West Hattiesburg Clinic Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN N BATSON (EXECUTIVE DIRECTOR)
(601) 264-6000
Entity
Organization
Contact information
Practice address
6855 LINCOLN ROAD EXT, SUITE 60, HATTIESBURG, MS 39402-3271
(601) 296-2960
(601) 296-2961
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-5463
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
05/16/2016
Last updated
02/22/2021
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