OAK GROVE FAMILY CLINIC (NPI# 1538378567) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538378567 |
| Entity Type | Organization |
| Organization Name | OAK GROVE FAMILY CLINIC |
| Practice Address |
5192 Old Highway 11 Suite 2 Hattiesburg MS 39402-6222 |
| Practice Telephone | 6012680929 |
| Practice Fax Number | 6012610508 |
| Mailing Telephone | 6012680929 |
| Mailing Fax Number | 6012610508 |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. GARY D CARR (PRESIDENT) |
| Authorized Official Telephone | 6012680929 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Street Address |
5192 OLD HIGHWAY 11 SUITE 2 |
| City | HATTIESBURG |
| State | MS |
| Zip Code | 39402-6222 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396847885 | Debra Lee Carr | Counselor | 5192 Old Highway 11, Hattiesburg, MS 39402-6222 | 2006-09-04 |
| 1265872782 | Hattiesburg Clinic Pa | Family Medicine | 5192 Old Highway 11, Suite 2, Hattiesburg, MS 39402-6222 | 2013-06-28 |
| 1831496603 | Aleza Marie Boyette | Nurse Practitioner | 5192 Old Highway 11, Hattiesburg, MS 39402-6222 | 2011-02-14 |
| 1851602569 | Melanie Keene Hall | Family Medicine | 5192 Old Highway 11, Suite 2, Hattiesburg, MS 39402-6222 | 2010-06-28 |
| 1881846681 | Lisa Boyer Gatwood | Nurse Practitioner | 5192 Old Highway 11, Hattiesburg, MS 39402-6222 | 2008-10-13 |
| 1548333610 | J D Dumas | Family Medicine | 5192 Old Highway 11, Suite 2, Hattiesburg, MS 39402 | 2006-11-16 |
| 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 | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205174521 | Med Management Plus | Clinic/Center | 6169 U S Highway 98, Suite 30, Hattiesburg, MS 39402-8533 | 2013-01-21 |
| 1447504501 | Solace Health, Pllc | Clinic/Center | 6855 Lincoln Road Ext, Ste 50, Hattiesburg, MS 39402-3271 | 2012-10-28 |
| 1750630232 | Health Partners, Pa | Clinic/Center | 1 Lincoln Pkwy, Suite 302, Hattiesburg, MS 39402-3262 | 2012-08-30 |
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|---|---|---|---|---|
| 1477176824 | Crystalcare | Clinic/Center | 3124 N Shiloh Road, Corinth, MS 38834 | 2020-05-20 |
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| 1720640899 | Home In The Woods Healthcare Clinic, LLC | Clinic/Center | 6572 County Road 514, Itta Bena, MS 38941-2746 | 2019-06-28 |
| 1366003436 | Blackwell's Family Medicine LLC | Clinic/Center | 107 Ball Ave, Tylertown, MS 39667-2101 | 2019-06-27 |
| 1710545488 | Primary and Behavioral Healthcare Services, Pa | Clinic/Center | 717 E. Fortification St., Jackson, MS 39202-2402 | 2019-05-29 |
| 1720559354 | Golden Years Geriatrics Inc. | Clinic/Center | 1233 County Road 108, New Albany, MS 38652-9787 | 2018-12-07 |
| 1316421373 | Children's International, LLC | Clinic/Center | 2003 Wildwood Rd, Picayune, MS 39466-2178 | 2018-09-17 |
| 1124505912 | Thaxton Family Medical Clinic LLC | Clinic/Center | 11145 Highway 6 W, Thaxton, MS 38871-9024 | 2018-07-24 |
| 1316439615 | Quad/med, LLC | Clinic/Center | 1000 Jere St. Pe' Hwy, C/o Ingalls Main Substation, 1st Floor, Pascagoula, MS 39567 | 2018-06-01 |
| 1194215681 | Brooks Medical Clinic | Clinic/Center | 2113 South Tate Street, Corinth, MS 38834 | 2018-05-10 |
| Find all providers with the same taxonomy | ||||
| City | HATTIESBURG |
| Zip Code | 39402 |
Please comment or provide details below to improve the information on OAK GROVE FAMILY CLINIC.
| 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.