HATTIESBURG CLINIC PA – NPI #1790871853
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.

HATTIESBURG CLINIC PA is a provider located in SUMRALL, MS. NPPES has assigned the NPI number 1790871853 to HATTIESBURG CLINIC PA on October 05, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. 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 HATTIESBURG CLINIC PA below.

NPI Profile for
HATTIESBURG CLINIC PA

NPI Number
1790871853
Enumeration Date

(more than 19 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
Primary location
1238 HIGHWAY 42
SUMRALL, MS 39482
Phone: (601) 758-3100 Fax: (601) 758-3060
Mailing address
415 S 28TH AVE
HATTIESBURG, MS 39401-7246
Phone: (601) 579-5463 Fax: (601) 579-5240
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.

Identifiers

Identifiers for HATTIESBURG CLINIC PA

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDMS00081762
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.