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6169 U S Highway 98 Suite 30 Hattiesburg MS 39402-8533 | |
| (601) 296-2552 | |
| (601) 296-2397 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Urgent Care |
| Location | 6169 U S Highway 98, Hattiesburg, Mississippi |
| Authorized Official Name and Position | Barry Monday (CEO) |
| Authorized Official Contact | 6012962552 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 17708 Hattiesburg MS 39404-7708 Ph: (601) 296-2552 | 6169 U S Highway 98 Suite 30 Hattiesburg MS 39402-8533 Ph: (601) 296-2552 |
| NPI Number | 1205174521 |
|---|---|
| Provider Enumeration Date | 01/21/2013 |
| Last Update Date | 01/21/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205174521 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Primary |
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