HATTIESBURG CLINIC PA (NPI# 1730276098) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730276098 |
| Entity Type | Organization |
| Organization Name | HATTIESBURG CLINIC PA |
| Other Organization Name | THE CHILDREN'S CLINIC |
| Practice Address |
4210 Lincoln Rd Hattiesburg MS 39402 |
| Mailing Address |
415 S 28th Ave Hattiesburg MS 39401-7246 |
| Practice Telephone | 6012613500 |
| Practice Fax Number | 6012613583 |
| Mailing Telephone | 6015795463 |
| Mailing Fax Number | 6015795240 |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2015-08-25 |
| Authorized Official Name | TOMMY G THORNTON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6012685601 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09016070 | 05 |
| Other Name | Type Code |
|---|---|
| The Children's Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831251925 | Hattiesburg Clinic Pa | Clinic/Center | 101 Courtenay Cir, Hattiesburg, MS 39402-3153 | 2006-12-14 |
| 1649332735 | Hattiesburg Clinic Pa | Psychologist | 2 Southern Point Pkwy Ste 201, Hattiesburg, MS 39401-8025 | 2006-12-14 |
| 1033270921 | Hattiesburg Clinic Pa | Internal Medicine | 940 Matthew Dr, Waynesboro, MS 39367-2522 | 2006-12-13 |
| 1184785065 | Hattiesburg Clinic Pa | Ophthalmology | 6414 Highway 98 West, Suite 80, Hattiesburg, MS 39402 | 2006-12-13 |
| 1417046574 | Hattiesburg Clinic Pa | Family Medicine | 2013 North Pine, Heidelberg, MS 39439 | 2006-10-12 |
| 1962599282 | Hattiesburg Clinic Pa | Physical Therapist | 206 Corinth Rd, Petal, MS 39465-2883 | 2006-10-06 |
| 1972690287 | Hattiesburg Clinic Pa | Ophthalmology | 321 S 11th Ave, Laurel, MS 39440-4316 | 2006-10-06 |
| 1114014479 | Hattiesburg Clinic Pa | Dermatology | 6 Medical Blvd, Hattiesburg, MS 39401-7230 | 2006-10-06 |
| 1104910322 | Hattiesburg Clinic Pa | Family Medicine | 300 Pine St, Taylorsville, MS 39168-5432 | 2006-10-03 |
| 1730272931 | Hattiesburg Clinic Pa | Family Medicine | 801 Main Ave S, Magee, MS 39111-4102 | 2006-10-02 |
| Street Address |
4210 LINCOLN RD |
| City | HATTIESBURG |
| State | MS |
| Zip Code | 39402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134239940 | Jeffrey C Williams | Pediatrics | 4210 Lincoln Rd, Hattiesburg, MS 39402 | 2006-08-30 |
| 1821697210 | Katie Scianna Moore | Nurse Practitioner | 4210 Lincoln Rd, Hattiesburg, MS 39402-3093 | 2020-10-19 |
| 1437618659 | Savannah Murray | Nurse Practitioner | 4210 Lincoln Rd, Hattiesburg, MS 39402-3093 | 2019-03-18 |
| 1477011161 | Felicia S Stewart | Nurse Practitioner | 4210 Lincoln Rd, Hattiesburg, MS 39402-3093 | 2019-03-12 |
| 1730568692 | Amanda Cesare Whiddon | Nurse Practitioner | 4210 Lincoln Rd, Hattiesburg, MS 39402 | 2015-05-26 |
| 1114331832 | Marla Turner Chapman | Internal Medicine | 4210 Lincoln Rd, Hattiesburg, MS 39402-3093 | 2014-06-20 |
| 1013357433 | Megan Dillon | Pediatrics | 4210 Lincoln Rd, Hattiesburg, MS 39402-3093 | 2013-06-29 |
| 1144517541 | Aprile Claire Gilmore | Pediatrics | 4210 Lincoln Rd, Hattiesburg, MS 39402 | 2011-07-06 |
| 1720216492 | Yakeyla Nave Naylor | Pediatrics | 4210 Lincoln Rd, Hattiesburg, MS 39402 | 2009-07-01 |
| 1154436574 | Pamela C Love | Nurse Practitioner | 4210 Lincoln Rd, Hattiesburg, MS 39402 | 2006-08-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518572965 | Resilient Therapy and Solutions, Pllc | Clinic/Center | 5266 Old Hwy 11 Ste 50, #308, Hattiesburg, MS 39402 | 2020-09-12 |
| 1932710225 | Jones County Medical Supplies, Inc | Durable Medical Equipment & Medical Supplies | 6424 Hwy 98 West, Suite 20, Hattiesburg, MS 39402 | 2020-08-11 |
| 1467086736 | Elizabeth A. Perry | Technician | 1220 Marrie St, Hattiesburg, MS 39402 | 2020-02-26 |
| 1225678063 | Connor Gregory Galloway | Physical Therapist | 3688 Veteran Memorial Drive, Hattiesburg, MS 39402 | 2020-01-09 |
| 1487291456 | Megan Marie Smith | Social Worker | 11 Woodstone Plaza, Hattiesburg, MS 39402 | 2019-12-09 |
| 1821656612 | Julie Covington Mcmahan | Dentist | 100 Madison Plaza, Hattiesburg, MS 39402 | 2019-06-05 |
| 1295392074 | Hattiesburg Clinic, Pa | Preventive Medicine | 6414 Highway 98, Suite 120, Hattiesburg, MS 39402 | 2019-05-28 |
| 1760945356 | Rachandeep Chahal | Student in an Organized Health Care Education/Training Program | 5001 Hardy Street Merit Health Wesley, Hattiesburg, MS 39402 | 2019-04-10 |
| 1386101137 | Courtney L Smith | Behavior Technician | 32 Millbanch Road, Suite 40, Hattiesburg, MS 39402 | 2019-02-28 |
| 1891269940 | Amanda Laine Mcarthur-macisaac | Registered Nurse | 5909 Highway 49 South, Suite 30, Hattiesburg, MS 39402 | 2019-01-11 |
| Find all providers in zip 39402 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427342849 | Ann K Fairey | Pediatrics | 2400 Mimosa Ln, Hattiesburg, MS 39402-2536 | 2011-06-02 |
| 1467695411 | John Rushing Jackson, Jr. | Pediatrics | 410 6th Ave, Hattiesburg, MS 39401-4290 | 2009-04-07 |
| 1134239940 | Jeffrey C Williams | Pediatrics | 4210 Lincoln Rd, Hattiesburg, MS 39402 | 2006-08-30 |
| 1598870917 | Samuel K Love | Pediatrics | 4210 Lincoln Road, Hattiesburg, MS 39402 | 2006-08-19 |
| 1184636847 | Leigh A Haden | Pediatrics | 4210 Lincoln Rd., Hattiesburg, MS 39402 | 2006-08-12 |
| 1588689061 | Lisa M Lancaster | Pediatrics | 5 Medical Blvd, Hattiesburg, MS 39401-7231 | 2006-07-13 |
| 1134174097 | Elizabeth M Felder | Pediatrics | 102 Medical Park, Hattiesburg, MS 39401-8025 | 2006-05-22 |
| 1144285420 | John Wells Gaudet | Pediatrics | 39 Franklin Rd, Ste. 200, Hattiesburg, MS 39402-1588 | 2006-04-19 |
| 1679576458 | Claire C Morgan | Pediatrics | 5003 Hardy St, Hattiesburg, MS 39402-1319 | 2005-05-24 |
| 1578095238 | Kristen Nicole Ramey | Pediatrics | 101 Medical Park, Hattiesburg, MS 39401-9042 | 2017-03-31 |
| Find all providers in HATTIESBURG | ||||
| City | HATTIESBURG |
| Zip Code | 39402 |
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.