HATTIESBURG CLINIC, P.A. (NPI# 1518175314) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1518175314 |
Entity Type | Organization |
Organization Name | HATTIESBURG CLINIC, P.A. |
Other Organization Name | 28TH PLACE |
Practice Address |
421 S 28th Ave Hattiesburg MS 39401-7206 |
Mailing Address |
415 S 28th Ave Hattiesburg MS 39401-7246 |
Practice Telephone | 6012685640 |
Practice Fax Number | 6012613507 |
Mailing Telephone | 6012685640 |
Mailing Fax Number | 6012613507 |
Enumeration Date | 2007-05-18 |
Last Update Date | 2010-08-05 |
Authorized Official Name | MR. TOMMY THORNTON (EXECUTIVE DIRECTOR) |
Authorized Official Telephone | 6012685601 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
Allopathic & Osteopathic Physicians | ||
N | 208200000X | Plastic Surgery | Allopathic & Osteopathic Physicians | ||
Y | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
28th Place | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255529228 | Hattiesburg Clinic, P.a. | Clinic/Center | 180 East Main Street, Pachuta, MS 39347 | 2007-10-04 |
Street Address |
421 S 28TH AVE |
City | HATTIESBURG |
State | MS |
Zip Code | 39401-7206 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073539409 | Laura N Keith | Nurse Practitioner | 421 S 28th Ave, Hattiesburg, MS 39401-7236 | 2006-07-15 |
1811302995 | Hattiesburg Clinic, Pa | Obstetrics & Gynecology | 421 S 28th Ave, Suite 120, Hattiesburg, MS 39401-7206 | 2014-06-26 |
1922435130 | Marlena Marie Bradley | Nurse Practitioner | 421 S 28th Ave, Suite 200, Hattiesburg, MS 39401-7206 | 2013-10-02 |
1659635027 | Amanda Dawn Sellers | Obstetrics & Gynecology | 421 S 28th Ave, Suite 200, Hattiesburg, MS 39401-7206 | 2012-06-29 |
1265744437 | Lauren Ayres Bethea | Obstetrics & Gynecology | 421 S 28th Ave, Suite 200, Hattiesburg, MS 39401-7206 | 2010-07-05 |
1518131754 | Benjamin C Moore | Obstetrics & Gynecology | 421 S 28th Ave, Suite 200, Hattiesburg, MS 39401-7206 | 2008-04-18 |
1891970521 | Marie M Darby | Obstetrics & Gynecology | 421 S 28th Ave, Suite 120, Hattiesburg, MS 39401-7206 | 2007-12-31 |
1447431465 | Jennifer Cain Bailey | Obstetrics & Gynecology | 421 S 28th Ave, Hattiesburg, MS 39401-7206 | 2007-11-19 |
1336351659 | Leigh Anne Strong | Pathology | 421 S 28th Ave, Hattiesburg, MS 39401-7236 | 2007-05-07 |
1982785820 | Hattiesburg Clinic Pa | Obstetrics & Gynecology | 421 S 28th Ave, Suite 200, Hattiesburg, MS 39401-7206 | 2006-10-18 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598315863 | Lisa Thornton | Technician | 18 Timberline Dr., Hattiesburg, MS 39401 | 2019-09-18 |
1548813637 | Caroline Estes Barnes | Counselor | Barnes, 8 App Slade Road, Hattiesburg, MS 39401 | 2019-07-18 |
1396252441 | Selection Healthcare Services, LLC | In Home Supportive Care | 606 Adeline St Ste 1c, Hattiesburg, MS 39401 | 2018-01-10 |
1225545585 | Whitney Wilkinson | Nurse Practitioner | 301 South 28th Avenue, Hattiesburg, MS 39401 | 2018-01-08 |
1740795806 | Forrest General Hospital | Pharmacy | 1414 South 28th Avenue, Hattiesburg, MS 39401 | 2017-12-11 |
1275058455 | Casey Payne | Pharmacist | 6130 Us 49, Hattiesburg, MS 39401 | 2017-08-08 |
1225562705 | Sarah Marie Hudson | Family Medicine | 6051 Us Highway 49 S, Hattiesburg, MS 39401 | 2017-04-12 |
1043671704 | The Covington's Cove Assisted Living Center LLC | Assisted Living Facility | 192 Mary Magdalene Church Rd, Hattiesburg, MS 39401 | 2016-03-09 |
1780083626 | Dominique Reed Watson | Pharmacist | 602 Adeline St, Hattiesburg, MS 39401 | 2014-08-15 |
1558778936 | Willie Davis Jr. | Day Training, Developmentally Disabled Services | 701 Duke Ave., Hattiesbiurg, MS 39401 | 2014-07-17 |
Find all providers in zip 39401 |
Taxonomy Code | 207VG0400X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Obstetrics & Gynecology |
Specialization | Gynecology |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881675312 | Hilda J Mcgee | Obstetrics & Gynecology | 62 Old Airport Rd, Hattiesburg, MS 39401-8382 | 2005-11-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982961728 | Laura Rebecca Daily | Obstetrics & Gynecology | 501 Marshall St Ste G07, Jackson, MS 39202-1651 | 2012-04-18 |
1093027385 | Lindsey Miller Turner | Obstetrics & Gynecology | 1020 River Oaks Dr Ste 320, Flowood, MS 39232-9512 | 2010-07-02 |
1891945440 | R C & P R Purohit Pa | Obstetrics & Gynecology | 135 Keating Road, Batesville, MS 38606 | 2008-09-19 |
1295915320 | Dr Mike Dorcik, Pa | Obstetrics & Gynecology | 12511 Mccully Dr, Biloxi, MS 39532-9091 | 2007-11-06 |
1902010986 | Wadie Hill Abraham II | Obstetrics & Gynecology | 2373 Highway 11 and 80, Toomsuba, MS 39364-9441 | 2007-05-09 |
1730213596 | Southcrest Women Healthcare | Obstetrics & Gynecology | 401south Crest Circle, Suite 101, Southaven, MS 38671 | 2007-03-15 |
1093815474 | Cecil Douglas Odom | Obstetrics & Gynecology | 1020 River Oaks Drive, Ste 310, Jackson, MS 39232 | 2006-09-25 |
1366551079 | E J Price Jr. | Obstetrics & Gynecology | 300 Rawls Drive, Suite 900, Mccomb, MS 39648 | 2006-08-29 |
1457375446 | Tommy Alexander | Obstetrics & Gynecology | 2010 E Shiloh Rd, Corinth, MS 38834-3724 | 2006-07-26 |
1104869148 | Natasha N Hardeman | Obstetrics & Gynecology | 2506 Lakeland Dr Ste 600, Flowood, MS 39232-7640 | 2006-06-14 |
Find all providers with the same taxonomy |
City | HATTIESBURG |
Zip Code | 39401 |
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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.