| Hattiesburg Clinic Pa | |
|
1407 S Main St Poplarville MS 39470-3369 | |
| (601) 795-0659 | |
| (601) 795-8639 |
| Full Name | Hattiesburg Clinic Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1407 S Main St, Poplarville, 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 1407 S Main St Poplarville MS 39470-3369 Ph: (601) 795-0659 |
| NPI Number | 1720188907 |
|---|---|
| Provider Enumeration Date | 09/25/2006 |
| Last Update Date | 02/22/2021 |
| Medicare PECOS PAC ID | 5193706794 |
|---|---|
| Medicare Enrollment ID | O20100930086177 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720188907 | NPI | - | NPPES |
| 09016107 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Children's International, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 345 Buck Kirkland Rd., Poplarville, MS 39470 Phone: 985-646-1580 Fax: 888-863-4274 | |
Pearl River Family Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 302 Highway 11 S, Poplarville, MS 39470 Phone: 601-403-8284 Fax: 601-403-8283 |