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HATTIESBURG CLINIC PA NPI 1265872782


NPI Information

NPI: 1265872782
Provider Name: HATTIESBURG CLINIC PA

Doing Business As: OAK GROVE FAMILY CLINIC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 25D0704296

Address:
5192 OLD HIGHWAY 11
SUITE 2
HATTIESBURG, MS
ZIP 39402
Phone: (601) 268-0929
Get Directions

HATTIESBURG CLINIC PA is a family medicine in Hattiesburg, MS. The provider is 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. HATTIESBURG CLINIC PA NPI is 1265872782. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Oak Grove Family Clinic.

The provider's business location address is:

5192 OLD HIGHWAY 11
SUITE 2
HATTIESBURG, MS
ZIP 39402-222
Phone: (601) 268-0929
Fax: (601) 261-0508

The provider's authorized official is Bryan N Batson .
The authorized official title is Executive Director and has the following contact phone number (601) 264-6000.

The CLIA number assigned to this NPI record is 25D0704296 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 6/28/2013 and was last updated on 2/18/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
104888240MEDICAIDMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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