SOUTH 28TH AVENUE FAMILY MEDICINE – NPI #1679053979
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Health Care Provider Taxonomy Code for Family Medicine

SOUTH 28TH AVENUE FAMILY MEDICINE is a provider located in HATTIESBURG, MS. NPPES has assigned the NPI number 1679053979 to SOUTH 28TH AVENUE FAMILY MEDICINE on August 16, 2018. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “SOUTH 28TH AVENUE FAMILY MEDICINE” is a dba name, the actual legal business name for this organization is HATTIESBURG CLINIC, PA. The primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

The NPI profile was previously updated about 5 years ago on Feb 22, 2021. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SOUTH 28TH AVENUE FAMILY MEDICINE below.

NPI Profile for
HATTIESBURG CLINIC, PA

NPI Number
1679053979
Enumeration Date

(about 8 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
HATTIESBURG CLINIC, PA
Doing Business As (dba): SOUTH 28TH AVENUE FAMILY MEDICINE
Primary location
SOUTH 28TH AVENUE FAMILY MEDICINE
1101 SOUTH 28TH AVENUE, SUITE C
HATTIESBURG, MS 39402
Phone: (601) 261-1670 Fax: (601) 579-5240
Mailing address
415 S 28TH AVE
HATTIESBURG, MS 39401-7246
Phone: (601) 261-1670 Fax: (601) 579-5463
Organization Subpart
No
Authorized Official
BRYAN BATSON
EXECUTIVE DIRECTOR
Phone: (601) 264-6000
Updated
Certification Date
Feb 22, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207Q00000X
- Family Medicine (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.