Organization
HATTIESBURG CLINIC, PA
Active
Other names
Columbia Dialysis Unit
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN N BATSON (EXECUTIVE DIRECTOR)
(601) 264-6000
Entity
Organization
Contact information
Practice address
1214 HIGHWAY 98 BYP, COLUMBIA, MS 39429-3703
(601) 731-1234
(601) 731-2952
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 731-6305
(601) 731-2952
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000050285
BLUE CROSS BLUE SHIELD MS
MS
05
—
00020341
—
MS
01
—
5000477
UNITED HEALTHCARE
MS
Enumeration date
07/09/2006
Last updated
04/12/2024
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