HATTIESBURG CLINIC, PA (NPI# 1811302995) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811302995 |
| Entity Type | Organization |
| Organization Name | HATTIESBURG CLINIC, PA |
| Other Organization Name | HATTIESBURG CLINIC DEPARTMENT OF MATERNAL-FETAL MEDICINE |
| Practice Address |
421 S 28th Ave Suite 120 Hattiesburg MS 39401-7206 |
| Mailing Address |
415 S 28th Ave Hattiesburg MS 39401-7246 |
| Practice Telephone | 6015795100 |
| Practice Fax Number | 6015793211 |
| Mailing Telephone | 6015795463 |
| Mailing Fax Number | 6015795240 |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2014-06-26 |
| Authorized Official Name | MR. TOMMY THORNTON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6015795463 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VM0101X |
Obstetrics & Gynecology Specialization: Maternal & Fetal Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Hattiesburg Clinic Department of Maternal-Fetal Medicine | Doing Business As Name - 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 |
421 S 28TH AVE SUITE 120 |
| 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 |
| 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 |
| 1518175314 | Hattiesburg Clinic, P.a. | Pathology | 421 S 28th Ave, Hattiesburg, MS 39401-7206 | 2007-05-18 |
| 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 | 207VM0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Maternal & Fetal Medicine |
| An obstetrician/gynecologist who cares for, or provides consultation on, patients with complications of pregnancy. This specialist has advanced knowledge of the obstetrical, medical and surgical complications of pregnancy and their effect on both the mother and the fetus. The specialist also possesses expertise in the most current diagnostic and treatment modalities used in the care of patients with complicated pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891970521 | Marie M Darby | Obstetrics & Gynecology | 421 S 28th Ave, Suite 120, Hattiesburg, MS 39401-7206 | 2007-12-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689282345 | Monroe Health Services, Inc. | Obstetrics & Gynecology | 1105 Earl Frye Blvd, Amory, MS 38821-5500 | 2020-07-20 |
| 1578966529 | Ochsner Clinic LLC | Obstetrics & Gynecology | 1721 Medical Park Dr, Biloxi, MS 39532-2109 | 2014-10-06 |
| 1922445188 | North Mississippi Medical Center, Inc. | Obstetrics & Gynecology | 4566 S Eason Blvd, Tupelo, MS 38801-6540 | 2013-05-29 |
| 1780843995 | Mississippi Maternal-fetal Medicine, P.a. | Obstetrics & Gynecology | 501 Marshall St, Suite 601, Jackson, MS 39202-1651 | 2008-06-03 |
| 1841332970 | James Martin Tucker | Obstetrics & Gynecology | 291 E Layfair Dr, Flowood, MS 39232-9527 | 2007-02-13 |
| 1316003114 | Kenneth G.perry Jr., M.d P.a | Obstetrics & Gynecology | 501 Marshall St, Ste 505, Jackson, MS 39202-1651 | 2006-12-28 |
| 1326073404 | Rick Martin | Obstetrics & Gynecology | 2500 N State St, Jackson, MS 39216-4500 | 2006-07-11 |
| 1699706390 | James Martin | Obstetrics & Gynecology | 2500 N State St, Jackson, MS 39216-4500 | 2006-07-05 |
| 1033154935 | James Bofill | Obstetrics & Gynecology | 2500 N State St, Jackson, MS 39216-4500 | 2006-06-17 |
| 1184661373 | Robert William Naef IIi | Obstetrics & Gynecology | 501 Marshall St, Suite 601, Jackson, MS 39202-1651 | 2006-05-31 |
| 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.