HATTIESBURG CLINIC, PA (NPI# 1245263540) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1245263540 |
Entity Type | Organization |
Organization Name | HATTIESBURG CLINIC, PA |
Other Organization Name | LAUREL DIALYSIS UNIT |
Practice Address |
1527 Larry Dr Laurel MS 39440-1932 |
Mailing Address |
415 S 28th Ave Hattiesburg MS 39401-7246 |
Practice Telephone | 6014251853 |
Practice Fax Number | 6014251877 |
Mailing Telephone | 6014251853 |
Mailing Fax Number | 6014251877 |
Enumeration Date | 2006-07-09 |
Last Update Date | 2020-10-07 |
Authorized Official Name | DR. BRYAN N BATSON (EXECUTIVE DIRECTOR) |
Authorized Official Telephone | 6012685601 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MS | 00020338 | 05 | |
MS | UNITED HEALTHCARE | 5000477 | 01 |
MS | BLUE CROSS BLUE SHIELD MS | 000050273 | 01 |
Other Name | Type Code |
---|---|
Laurel Dialysis Unit | 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 |
1821021155 | Hattiesburg Clinic, Pa | Clinic/Center | 4820 Plaza Dr, Tylertown, MS 39667-9221 | 2006-07-09 |
Street Address |
1527 LARRY DR |
City | LAUREL |
State | MS |
Zip Code | 39440-1932 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306323159 | Tender Loving Care Homecare LLC | Homemaker | 509 Central Ave Ste 224, Laurel, MS 39440 | 2018-07-24 |
1669837910 | Laurel Dental Properties | Dentist | 1925 Pine Belt Drive, Laurel, MS 39440 | 2015-12-30 |
1215282991 | South Central Regional Medical Center | Clinic/Center | 525 Wayne Drive, Laurel, MS 39440 | 2012-07-18 |
1568721215 | Terry Ratcliff Perkins | Counselor | 5192 Hwy 11 North, Laurel, MS 39440 | 2012-05-15 |
1437453057 | Alexander Milne Home for Women | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 616 East 19th Street, Laurel, MS 39440 | 2010-12-23 |
1710135629 | Jeffrey R. Moffett | Nurse Practitioner | 3115 Audubon Dr, Laurel, MS 39440 | 2008-09-04 |
1003096785 | Family Health Center, Inc | Obstetrics & Gynecology | 103 S. 12th Avenue, Laurel, MS 39440 | 2007-11-09 |
1669672143 | Laurel Urology Clinic Pa | Urology | 304 S 10th Ave, Laurel, MS 39440 | 2007-07-23 |
1093912370 | Tanweer Hussain Majid | Surgery | 1007 Jefferson Street, Laurel, MS 39440 | 2007-06-29 |
1780889923 | Hattiesburg Eye Clinic, Pa | Ophthalmology | 1431 North 10th St, Suite 1, Laurel, MS 39440 | 2007-06-18 |
Find all providers in zip 39440 |
Taxonomy Code | 261QE0700X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | End-Stage Renal Disease (ESRD) Treatment |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235667130 | Conecuh Dialysis LLC | Clinic/Center | 14500 Laurel Pl, Laurel, MD 20707-4961 | 2017-05-23 |
1184028433 | Dsi Laurel, LLC | Clinic/Center | 30214 Sussex Hwy, Laurel, DE 19956-3880 | 2014-10-15 |
1902866999 | Renal Treatment Centers Mid Atlantic Inc | Clinic/Center | 14631 Laurel Bowie Road, Units 100 - 105, Laurel, MD 20707 | 2006-03-24 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760092878 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 5722 I-55 N Frontage Road, Jackson, MS 39211 | 2020-08-04 |
1952910457 | Fresenius Medical Care East Mccomb Dialysis, LLC | Clinic/Center | 103 Business Center Drive, Mccomb, MS 39648 | 2020-07-30 |
1013535780 | Fresenius Medical Care Meridian Home, LLC | Clinic/Center | 2400 15th St, Meridian, MS 39301-3951 | 2020-07-09 |
1922631837 | Fresenius Medical Care Dogwood, LLC | Clinic/Center | 205b Belle Meade Pt, Flowood, MS 39232-3311 | 2020-02-19 |
1669944120 | Fresenius Medical Care Adams County Home, LLC | Clinic/Center | 151 Jefferson Davis Blvd Ste D, Natchez, MS 39120-5140 | 2018-12-21 |
1205334513 | Renal Care Group Tupelo, LLC | Clinic/Center | 1031 S Madison St, Tupelo, MS 38801-6309 | 2018-02-01 |
1801310768 | Hattiesburg Clinic, Pa | Clinic/Center | 5909 Hwy 49 S, Suite 14, Hattiesburg, MS 39402-2860 | 2017-08-01 |
1184146789 | Lakeland Home Program LLC | Clinic/Center | 209 Mar Lyn Dr, Brandon, MS 39042 | 2017-07-14 |
1932636495 | Rcg Mississippi, Inc. | Clinic/Center | 1300 38th Ave E, Meridian, MS 39301 | 2017-05-16 |
1710411707 | Rcg Mississippi, Inc. | Clinic/Center | 1100 Central Drive, Philadelphia, MS 39350 | 2017-04-17 |
Find all providers with the same taxonomy |
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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.