| Hattiesburg Clinic, Pa | |
|
1 Lincoln Pkwy Ste 302 Hattiesburg MS 39402-3261 | |
| (601) 268-5620 | |
| (601) 268-5851 |
| Full Name | Hattiesburg Clinic, Pa |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 1 Lincoln Pkwy Ste 302, Hattiesburg, Mississippi |
| Authorized Official Name and Position | Bryan N Batson (CEO) |
| Authorized Official Contact | 6012616000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hattiesburg Clinic, Pa 415 S 28th Ave Hattiesburg MS 39401-7246 Ph: (601) 268-5620 | Hattiesburg Clinic, Pa 1 Lincoln Pkwy Ste 302 Hattiesburg MS 39402-3261 Ph: (601) 268-5620 |
| NPI Number | 1619543527 |
|---|---|
| Provider Enumeration Date | 06/01/2021 |
| Last Update Date | 06/01/2021 |
| Certification Date | 06/01/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619543527 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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