National Provider Identifier Database

HATTIESBURG CLINIC PA
Body Imaging

A Radiology doctor of Osteopathy that specializes in Body Imaging.


Contact Information

HATTIESBURG CLINIC PA
415 S 28TH AVE
HATTIESBURG, MS39401-7246
Phone: 601-268-5707
Fax: 601-268-5813
Website:
Specialty Taxonomy Code
* Body Imaging 2085B0100X
Diagnostic Radiology 2085R0202X
Diagnostic Ultrasound 2085U0001X
Neuroradiology 2085N0700X
Nuclear Radiology 2085N0904X
Pediatric Radiology 2085P0229X
Vascular & Interventional Radiology 2085R0204X

* Indicates primary specialty

NPI Profile & details for HATTIESBURG CLINIC PA

NPI Number 1265502652
Legal business name
LBN
HATTIESBURG CLINIC PA
Authorized official BRYAN BATSON - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 11/09/2006
Last updated 10/07/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • MS Medicaid: 00503777

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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