Organization
HATTIESBURG CLINIC PA
Active
Other names
Pathology/Dermatopathology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN N BATSON (EXECUTIVE DIRECTOR)
(601) 264-6000
Entity
Organization
Contact information
Practice address
421 S 28TH AVE, SUITE 310, HATTIESBURG, MS 39401-7206
(601) 579-5261
(601) 579-5257
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-5261
(601) 579-5257
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08722873
—
MS
Enumeration date
10/11/2006
Last updated
02/22/2021
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