Organization
HATTIESBURG CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN N BATSON (EXECUTIVE DIRECTOR)
(601) 264-6000
Entity
Organization
Contact information
Practice address
1238 HIGHWAY 42, SUMRALL, MS 39482
(601) 758-3100
(601) 758-3060
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-5463
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00081762
—
MS
Enumeration date
10/05/2006
Last updated
02/22/2021
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