FOOT CLINIC OF HATTIESBURG, P.A. (NPI# 1144316092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144316092 |
| Entity Type | Organization |
| Organization Name | FOOT CLINIC OF HATTIESBURG, P.A. |
| Practice Address |
710 S 28th Ave Ste B Hattiesburg MS 39402-2585 |
| Practice Telephone | 6012645793 |
| Mailing Telephone | 6012645793 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | STEPHEN PONTON (OWNER) |
| Authorized Official Telephone | 6012645793 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
80087 | MS | Podiatric Medicine & Surgery Service Providers |
| Street Address |
710 S 28TH AVE STE B |
| City | HATTIESBURG |
| State | MS |
| Zip Code | 39402-2585 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609102573 | Safeheart Health Screens | Physiological Laboratory | 710 S 28th Ave, Suite A, Hattiesburg, MS 39402-2585 | 2009-10-27 |
| 1336372127 | Community Hospice, LLC | Hospice Care, Community Based | 710 S 28th Ave, Suite C, Hattiesburg, MS 39402-2585 | 2009-08-27 |
| 1376670869 | Hattiesburg Clinic Pa | Internal Medicine | 710 S 28th Ave, Suite D, Hattiesburg, MS 39402-2585 | 2007-02-28 |
| 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 | 213EP1101X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Primary Podiatric Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336594985 | Nkechinyere Christina Nwoko | Podiatrist | 46 Sgt Prentiss Dr Ste 201b, Natchez, MS 39120 | 2016-05-02 |
| 1770942146 | Sarah Lynn Freed | Podiatrist | 9065 Sandidge Center Cv Ste C, Olive Branch, MS 38654-3574 | 2016-02-15 |
| 1609996982 | Larry K Cruel | Podiatrist | 4510 Office Park Dr, Jackson, MS 39206-6016 | 2007-03-30 |
| 1740309590 | Madison Foot Clinic, Pllc | Podiatrist | 980 Highway 51 Ste B, Madison, MS 39110-8409 | 2007-03-29 |
| 1386715514 | Bruce K. Boyd | Podiatrist | 211 Alcorn Dr, Corinth, MS 38834-8400 | 2006-11-10 |
| 1376561779 | Ricky Roach | Podiatrist | 999 N Halstead Rd, Ocean Springs, MS 39564-3105 | 2006-07-17 |
| 1972537041 | Willie James Lewis Sr. | Podiatrist | 128 Poindexter St, Jackson, MS 39203-3048 | 2006-07-11 |
| 1790779858 | Rose Marie Sotolongo | Podiatrist | 731 S Pear Orchard Rd, Suite 7, Ridgeland, MS 39157-4800 | 2005-09-06 |
| 1598037798 | Oh for Feet Sake, LLC. | Podiatrist | 368 Scarbrough St, Suite B, Richland, MS 39218-9038 | 2012-02-02 |
| 1497957120 | Advanced Foot Care Center | Podiatrist | 4510 Office Park Dr, Jackson, MS 39206-6016 | 2007-06-04 |
| Find all providers with the same taxonomy | ||||
| City | HATTIESBURG |
| Zip Code | 39402 |
Please comment or provide details below to improve the information on FOOT CLINIC OF HATTIESBURG, P.A..
| 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.