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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
Monticello Family Medicine | Other Name - Individual/Organization |
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 |
Street Address |
128 COURTHOUSE SQ |
City | MONTICELLO |
State | MS |
Zip Code | 39654-6014 |
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 |
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 Code | 207Q00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | 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. |
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. |
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 |
City | MONTICELLO |
Zip Code | 39654 |
Please comment or provide details below to improve the information on HATTIESBURG CLINIC, PA.
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.