| Hattiesburg Clinic Pa | |
|
822 Main St Ellisville MS 39437-2425 | |
| (601) 477-2014 | |
| (601) 477-9942 |
| Full Name | Hattiesburg Clinic Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 822 Main St, Ellisville, Mississippi |
| Authorized Official Name and Position | Bryan N Batson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6012646000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hattiesburg Clinic Pa 415 S 28th Ave Hattiesburg MS 39401-7246 Ph: (601) 579-5463 | Hattiesburg Clinic Pa 822 Main St Ellisville MS 39437-2425 Ph: (601) 477-2014 |
| NPI Number | 1457451775 |
|---|---|
| Provider Enumeration Date | 09/25/2006 |
| Last Update Date | 02/18/2021 |
| Medicare PECOS PAC ID | 5193706794 |
|---|---|
| Medicare Enrollment ID | O20100930032275 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457451775 | NPI | - | NPPES |
| 06238274 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Family Health Center Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5192 Highway 11 N, Ellisville, MS 39437 Phone: 601-425-3033 Fax: 601-428-6561 | |
Jfmc Ellisville, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 602 Hill St, Ellisville, MS 39437 Phone: 601-719-0092 Fax: 601-719-0473 | |
Ellisville Pediatric Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1203 Ave B, Suite 200, Ellisville, MS 39437 Phone: 601-477-3550 Fax: 601-477-2236 | |
Ellisville State School Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1101 Hwy 11 S, Ellisville, MS 39437 Phone: 601-477-9384 Fax: 601-477-5700 | |
Fast Pace Mississippi, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 305 Hill St, Ellisville, MS 39437 Phone: 601-800-0118 | |
Ellisville Medical Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1203 Avenue B, Ellisville, MS 39437 Phone: 601-477-8553 Fax: 601-477-9158 |