HATTIESBURG CLINIC PA (NPI# 1336534270) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336534270 |
| Entity Type | Organization |
| Organization Name | HATTIESBURG CLINIC PA |
| Other Organization Name | PAIN MANAGEMENT HEALTH CENTER |
| Practice Address |
1 Lincoln Pkwy Ste 103 Hattiesburg MS 39402-3261 |
| Mailing Address |
415 S 28th Ave Hattiesburg MS 39401-7246 |
| Practice Telephone | 6012611600 |
| Mailing Telephone | 6015795463 |
| Mailing Fax Number | 6015795240 |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2015-03-30 |
| Authorized Official Name | TOMMY G THORNTON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6012685601 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Pain Management Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831251925 | Hattiesburg Clinic Pa | Clinic/Center | 101 Courtenay Cir, Hattiesburg, MS 39402-3153 | 2006-12-14 |
| 1649332735 | Hattiesburg Clinic Pa | Psychologist | 2 Southern Point Pkwy Ste 201, Hattiesburg, MS 39401-8025 | 2006-12-14 |
| 1033270921 | Hattiesburg Clinic Pa | Internal Medicine | 940 Matthew Dr, Waynesboro, MS 39367-2522 | 2006-12-13 |
| 1184785065 | Hattiesburg Clinic Pa | Ophthalmology | 6414 Highway 98 West, Suite 80, Hattiesburg, MS 39402 | 2006-12-13 |
| 1417046574 | Hattiesburg Clinic Pa | Family Medicine | 2013 North Pine, Heidelberg, MS 39439 | 2006-10-12 |
| 1962599282 | Hattiesburg Clinic Pa | Physical Therapist | 206 Corinth Rd, Petal, MS 39465-2883 | 2006-10-06 |
| 1972690287 | Hattiesburg Clinic Pa | Ophthalmology | 321 S 11th Ave, Laurel, MS 39440-4316 | 2006-10-06 |
| 1114014479 | Hattiesburg Clinic Pa | Dermatology | 6 Medical Blvd, Hattiesburg, MS 39401-7230 | 2006-10-06 |
| 1104910322 | Hattiesburg Clinic Pa | Family Medicine | 300 Pine St, Taylorsville, MS 39168-5432 | 2006-10-03 |
| 1730272931 | Hattiesburg Clinic Pa | Family Medicine | 801 Main Ave S, Magee, MS 39111-4102 | 2006-10-02 |
| Street Address |
1 LINCOLN PKWY STE 103 |
| City | HATTIESBURG |
| State | MS |
| Zip Code | 39402-3261 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699064659 | John E. Marsh | Nurse Practitioner | 1 Lincoln Pkwy Ste 103, Hattiesburg, MS 39402-3261 | 2011-03-30 |
| 1427591627 | Lauren Brewer Beckman | Nurse Practitioner | 1 Lincoln Pkwy Ste 103, Hattiesburg, MS 39402-3261 | 2016-11-21 |
| 1033537212 | Jonathan H.s. Rayburn | Anesthesiology | 1 Lincoln Pkwy Ste 103, Hattiesburg, MS 39402-3261 | 2014-04-03 |
| 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 | 2081P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pain Medicine |
| A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811929292 | Yvette Susi Folse | Physical Medicine & Rehabilitation | 3688 Veterans Memorial Dr, Suite 200, Hattiesburg, MS 39401-8246 | 2006-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417342452 | Total Rehabilitation Solutions, LLC | Physical Medicine & Rehabilitation | 232b Eisenhower Dr, Biloxi, MS 39531-3601 | 2015-04-06 |
| 1598847683 | Mansoor -- Hasan | Physical Medicine & Rehabilitation | Gv Sonny Montgomery Vamc Phy&rehab (117), 1500 E Woodrow Wilson Drive, Jackson, MS 39157 | 2006-10-19 |
| 1619178100 | Ms Pmr & Pmc, Pllc | Physical Medicine & Rehabilitation | 144 S Thomas St, Building 1, Suite 101-2, Tupelo, MS 38801-5312 | 2007-05-30 |
| 1528276284 | Matthew Quin Barfield | Physical Medicine & Rehabilitation | 4105 Hospital St, Suite 112b, Pascagoula, MS 39581-5312 | 2007-05-18 |
| 1598883266 | Bruce Edward Porter | Physical Medicine & Rehabilitation | 144 S Thomas St, Building Number 1 Suite 101-2, Tupelo, MS 38801-5312 | 2007-03-27 |
| 1033271416 | Gulf States Physical Medicine & Rehabilitation | Physical Medicine & Rehabilitation | 1190 N State St, Suite 202, Jackson, MS 39202-2413 | 2006-12-14 |
| City | HATTIESBURG |
| Zip Code | 39402 |
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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.