HATTIESBURG CLINIC, PA


Address: 128 Courthouse Sq, Monticello, MS 39654-6014
Phone: 6015870209

HATTIESBURG CLINIC, PA (NPI# 1275073512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1275073512
Entity Type Organization
Organization Name HATTIESBURG CLINIC, PA
Other Organization Name MONTICELLO FAMILY MEDICINE
Practice Address 128 Courthouse Sq
Monticello
MS 39654-6014
Mailing Address 415 S 28th Ave
Hattiesburg
MS 39401-7246
Practice Telephone 6015870209
Practice Fax Number 6015870436
Mailing Telephone 6015870209
Mailing Fax Number 6015795240
Enumeration Date 2017-03-06
Last Update Date 2017-03-06
Authorized Official Name TOMMY THORNTON (EXECUTIVE DIRECTOR)
Authorized Official Telephone 6012646000
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Q00000X Family Medicine Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
Monticello Family Medicine Other Name - Individual/Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1295392074 Hattiesburg Clinic, Pa Preventive Medicine 6414 Highway 98, Suite 120, Hattiesburg, MS 39402 2019-05-28
1679053979 Hattiesburg Clinic, Pa Family Medicine South 28th Avenue Family Medicine, 1101 South 28th Avenue, Suite C, Hattiesburg, MS 39402 2018-08-16
1750882080 Hattiesburg Clinic, Pa Physical Medicine & Rehabilitation 2 Southern Point Pkwy Ste 200, Hattiesburg, MS 39401-8025 2018-02-22
1801310768 Hattiesburg Clinic, Pa Clinic/Center 5909 Hwy 49 S, Suite 14, Hattiesburg, MS 39402-2860 2017-08-01
1346780681 Hattiesburg Clinic, Pa Family Medicine 202 E Main Ave, Lumberton, MS 39455-2608 2017-03-06
1356781082 Hattiesburg Clinic, Pa Family Medicine 6941 Highway 11 N, Suite A, Carriere, MS 39426-7793 2013-06-26
1689830549 Hattiesburg Clinic, Pa Physical Therapist 1403 S Main St Ste E, Poplarville, MS 39470-3394 2008-07-31
1841494895 Hattiesburg Clinic, Pa Clinic/Center 103 Asbury Cir, Hattiesburg, MS 39402-1302 2007-06-13
1669405981 Hattiesburg Clinic, Pa Clinic/Center 14 Bay Ave, Bay Springs, MS 39422-9206 2006-07-09
1245263540 Hattiesburg Clinic, Pa Clinic/Center 1527 Larry Dr, Laurel, MS 39440-1932 2006-07-09

Office Location

Street Address 128 COURTHOUSE SQ
City MONTICELLO
State MS
Zip Code 39654-6014

Providers in the same location

NPI Name Taxonomy Address Enumeration
1326248774 James Wyatt Stephens Family Medicine 128 Courthouse Sq, Monticello, MS 39654-6014 2007-07-24
1508022237 James W Stephens Md Family Medicine Pllc Clinic/Center 128 Courthouse Sq, Monticello, MS 39654-6014 2008-08-01

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1013558824 Downhome Pharmacy, Inc. Pharmacy 606 W. Broad St, Monticello, MS 39654 2019-10-02
1700344066 Southwest Mississippi Regional Medical Center Surgery 1065 E Broad St., Monticello, MS 39654 2019-03-06
1457862229 Susan Nevels Pharmacist 1509 Highway 84 West, Monticello, MS 39654 2017-10-19
1326565417 David Warren Ready Pharmacist 1509 Hwy 84 West, Monticello, MS 39654 2017-08-29
1861664575 James Mikel Griffith II Physical Therapy Assistant 314 Main St, Ste C, Monticello, MS 39654 2008-04-02
1811169840 Southwest Mississippi Planning and Development District Clinic/Center 1477 Fe Sellers Highway, Monticello, MS 39654 2008-03-31
1447429089 Foot and Wound Institute of The South Clinic/Center 157 Fe Sellers Highway, Monticello, MS 39654 2008-02-28
1346431566 Amy Eaton Broome Physical Therapy Assistant 314 Main St Ste C, Monticello, MS 39654 2007-08-05
1881804532 Chris Gilbert Boyd Dentist 716 Brookhaven Street, Monticello, MS 39654 2007-05-23
1851463707 Brantley B. Pace Family Medicine 713 Watts St., Monticello, MS 39654 2006-11-15
Find all providers in zip 39654

Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

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.
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition]
- Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences.
- Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1679914675 Mitchell Hammel Family Medicine 100 W Washington St Ste 101, Monticello, IL 61856-1713 2013-07-08
1700225679 Michael Ray Nielson Family Medicine 380 W. 100 North, Monticello, UT 84535 2013-06-24
1740415611 Julia Danielle Nicholson Family Medicine 906 Roberts Drive, Monticello, AR 71655 2009-05-21
1053566232 Monticello Family Medicine & Walk-in Center Family Medicine 10 Prince St Ste 7, Monticello, NY 12701-1919 2008-12-01
1326248774 James Wyatt Stephens Family Medicine 128 Courthouse Sq, Monticello, MS 39654-6014 2007-07-24
1548464993 Fredy H Cordova Family Medicine 766 Hl Ross Dr, Monticello, AR 71655 2007-06-11
1629141494 Bonita C Musial Family Medicine 314 Main St., Suite D, Monticello, MS 39654-0949 2006-11-17
1851463707 Brantley B. Pace Family Medicine 713 Watts St., Monticello, MS 39654 2006-11-15
1790865624 Christine M Foster Family Medicine 1293 N Main St Ste 102, Monticello, KY 42633-1945 2006-10-16
1962598490 Abraham G. Garfinkel Family Medicine 15 Hamilton Ave, Monticello, NY 12701-1319 2006-10-04
Find all providers in MONTICELLO

Competitor

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City MONTICELLO
Zip Code 39654

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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