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Contact Information

HATTIESBURG CLINIC PA
101 MEDICAL PARK
HATTIESBURG, MS39401
 Phone: 601-579-3000
 Fax: 601-579-5240
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for HATTIESBURG CLINIC PA · (Female)

NPI Number 1497837801
Status Active
Credentials
Entity Individual
Enumeration date 10/19/2006
Last updated 02/18/2021 - About 5 years ago
Sole proprietor 1 Not specified
Identifiers
  • MS Medicaid 09014653
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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