HATTIESBURG CLINIC PA (NPI# 1689763534) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689763534 |
| Entity Type | Organization |
| Organization Name | HATTIESBURG CLINIC PA |
| Other Organization Name | HEART CARE CENTER, THE |
| Practice Address |
404 S 13th Ave Laurel MS 39440-4345 |
| Mailing Address |
415 S 28th Ave Hattiesburg MS 39401-7246 |
| Practice Telephone | 6014255544 |
| Practice Fax Number | 6014255525 |
| Mailing Telephone | 6014255544 |
| Mailing Fax Number | 6014255525 |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2014-08-27 |
| 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 | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09014350 | 05 |
| Other Name | Type Code |
|---|---|
| Heart Care Center, The | 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 |
404 S 13TH AVE |
| City | LAUREL |
| State | MS |
| Zip Code | 39440-4345 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780799965 | Wassim E Mouannes | Internal Medicine | 404 S 13th Ave, Laurel, MS 39440-4345 | 2006-08-20 |
| 1013567445 | Jessica Watson Lott | Nurse Practitioner | 404 S 13th Ave, Laurel, MS 39440-4345 | 2019-09-17 |
| 1063625325 | Bassam K Mechleb | Internal Medicine | 404 S 13th Ave, Laurel, MS 39440-4345 | 2007-05-07 |
| 1518020999 | Pain Treatment Center of Laurel LLC | Clinic/Center | 404 S 13th Ave, Laurel, MS 39440-4345 | 2006-12-18 |
| 1538277843 | Joseph A Proli | Internal Medicine | 404 S 13th Ave, Laurel, MS 39440-4345 | 2006-08-27 |
| 1407964844 | Kenneth S Parker | Nurse Practitioner | 404 S 13th Ave, Laurel, MS 39440-4345 | 2006-08-27 |
| 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 | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780799965 | Wassim E Mouannes | Internal Medicine | 404 S 13th Ave, Laurel, MS 39440-4345 | 2006-08-20 |
| 1356358246 | Muhammad Yusuf | Internal Medicine | 13631 Baltimore Ave, Laurel, MD 20707 | 2006-08-02 |
| 1801835087 | South Central Clinics, Inc | Internal Medicine | 1440 Jefferson St, Laurel, MS 39440-4243 | 2006-06-05 |
| 1457878969 | South Central Clinics, Inc | Internal Medicine | 1203 Jefferson St, Laurel, MS 39440-4354 | 2017-08-25 |
| 1063625325 | Bassam K Mechleb | Internal Medicine | 404 S 13th Ave, Laurel, MS 39440-4345 | 2007-05-07 |
| 1881731263 | Christine Delima Md Pa | Internal Medicine | 7350 Van Dusen Rd, Suite 260, Laurel, MD 20707-5242 | 2007-02-01 |
| 1194879080 | Michael E Carlos Md LLC | Internal Medicine | 14201 Laurel Park Dr, Suite 223, Laurel, MD 20707-5203 | 2007-01-22 |
| 1285722108 | Jefferson Medical Associates | Internal Medicine | 1203 Jefferson St, Laurel, MS 39440-4354 | 2006-10-10 |
| 1104925122 | Feroz A Padder | Internal Medicine | 7350 Van Dusen Rd, Suite B 40, Laurel, MD 20707-5263 | 2006-09-22 |
| 1538277843 | Joseph A Proli | Internal Medicine | 404 S 13th Ave, Laurel, MS 39440-4345 | 2006-08-27 |
| Find all providers in LAUREL | ||||
Please comment or provide details below to improve the information on HATTIESBURG CLINIC PA.
| 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.