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HATTIESBURG CLINIC PA NPI 1295835544


NPI Information

NPI: 1295835544
Provider Name: HATTIESBURG CLINIC PA

Doing Business As: COLUMBIA FAMILY CLINIC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 25D0662431

Address:
502 BROAD ST
COLUMBIA, MS
ZIP 39429
Phone: (601) 736-8282
Get Directions

HATTIESBURG CLINIC PA is a family medicine in Columbia, 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 1295835544. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Columbia Family Clinic.

The provider's business location address is:

502 BROAD ST
COLUMBIA, MS
ZIP 39429-037
Phone: (601) 736-8282
Fax: (601) 736-8333

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 25D0662431 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 9/25/2006 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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
109013842MEDICAIDMISSISSIPPI

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: 5/5/2024

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