Hattiesburg Clinic Pa in Hattiesburg - Sports Medicine
Hattiesburg Clinic Pa - NPI 1871674754
Hattiesburg Clinic Pa is a Sports Medicine in Hattiesburg, Mississippi. Hattiesburg Clinic Pa practices all healthcare services and medical treatments related to Sports Medicine. The NPI Number for Hattiesburg Clinic Pa is 1871674754. The last update date is 2021-02-23.
Hattiesburg Clinic Pa's current location address is 415 S 28th Ave, Hattiesburg, Mississippi. You can contact this provider via phone number 6015795406 and fax number 6012685756. The mailing address for Hattiesburg Clinic Pa is 415 S 28th Ave, Hattiesburg, Mississippi. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Hattiesburg Clinic Pa |
|---|---|
| Address | 415 S 28th Ave, Hattiesburg, Mississippi |
| Phone Number | 6015795406 |
| Fax Number | 6012685756 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | EXECUTIVE |
|---|---|
| Authorized Official Name | Batson N Bryan |
| Telephone Number | 6012646000 |
NPI Number Detail
| NPI Number | 1871674754 |
|---|---|
| Provider Enumeration Date | 2006-10-18 |
| Last Updated Date | 2021-02-23 |
Provider Mailing Address Detail
| Address | 415 S 28th Ave |
|---|---|
| City | Hattiesburg |
| State | Mississippi (MS) |
| Post Code | 394017246 |
| Phone Number | 6015795406 |
| Fax Number | 6012685756 |
Provider's Primary Taxonomy Detail
| Speciality | Sports Medicine |
|---|---|
| Taxonomy | 2083S0010X |
|
Definition: A preventive medicine physician who specializes in the diagnosis and treatment of sports related conditions and injuries. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 6389072 | MS | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Hattiesburg Clinic Pa by the Centers for Medicare & Medicaid Services (CMS)?
The Hattiesburg Clinic Pa has been assigned the NPI (National Provider Identifier) 1871674754. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Can you provide the Hattiesburg Clinic Pa's physical address?
The Hattiesburg Clinic Pa is physically located at 415 S 28Th Ave, in the city of Hattiesburg, MS, with the postal code 394017246.
What is the Hattiesburg Clinic Pa's specialty and taxonomy code?
The Hattiesburg Clinic Pa's specialty is Sports Medicine, and the corresponding taxonomy code is 2083S0010X.
On what date was the 1871674754 assigned to Hattiesburg Clinic Pa?
The Hattiesburg Clinic Pa was issued its 1871674754 on 2006-10-18, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information pertaining to Hattiesburg Clinic Pa, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Hattiesburg Clinic Pa, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2021-02-23.