HATTIESBURG CLINIC PA (NPI# 1770672768) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770672768 |
| Entity Type | Organization |
| Organization Name | HATTIESBURG CLINIC PA |
| Other Organization Name | PATHOLOGY/DERMATOPATHOLOGY |
| Practice Address |
421 S 28th Ave Suite 310 Hattiesburg MS 39401-7206 |
| Mailing Address |
415 S 28th Ave Hattiesburg MS 39401-7246 |
| Practice Telephone | 6015795261 |
| Practice Fax Number | 6015795257 |
| Mailing Telephone | 6015795261 |
| Mailing Fax Number | 6015795257 |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2013-02-07 |
| 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 |
|---|---|---|---|---|---|
| N | 207ZD0900X |
Pathology Specialization: Dermatopathology |
Allopathic & Osteopathic Physicians | ||
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 08722873 | 05 |
| Other Name | Type Code |
|---|---|
| Pathology/Dermatopathology | 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 |
421 S 28TH AVE SUITE 310 |
| City | HATTIESBURG |
| State | MS |
| Zip Code | 39401-7206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073539409 | Laura N Keith | Nurse Practitioner | 421 S 28th Ave, Hattiesburg, MS 39401-7236 | 2006-07-15 |
| 1811302995 | Hattiesburg Clinic, Pa | Obstetrics & Gynecology | 421 S 28th Ave, Suite 120, Hattiesburg, MS 39401-7206 | 2014-06-26 |
| 1922435130 | Marlena Marie Bradley | Nurse Practitioner | 421 S 28th Ave, Suite 200, Hattiesburg, MS 39401-7206 | 2013-10-02 |
| 1659635027 | Amanda Dawn Sellers | Obstetrics & Gynecology | 421 S 28th Ave, Suite 200, Hattiesburg, MS 39401-7206 | 2012-06-29 |
| 1265744437 | Lauren Ayres Bethea | Obstetrics & Gynecology | 421 S 28th Ave, Suite 200, Hattiesburg, MS 39401-7206 | 2010-07-05 |
| 1518131754 | Benjamin C Moore | Obstetrics & Gynecology | 421 S 28th Ave, Suite 200, Hattiesburg, MS 39401-7206 | 2008-04-18 |
| 1891970521 | Marie M Darby | Obstetrics & Gynecology | 421 S 28th Ave, Suite 120, Hattiesburg, MS 39401-7206 | 2007-12-31 |
| 1447431465 | Jennifer Cain Bailey | Obstetrics & Gynecology | 421 S 28th Ave, Hattiesburg, MS 39401-7206 | 2007-11-19 |
| 1518175314 | Hattiesburg Clinic, P.a. | Pathology | 421 S 28th Ave, Hattiesburg, MS 39401-7206 | 2007-05-18 |
| 1336351659 | Leigh Anne Strong | Pathology | 421 S 28th Ave, Hattiesburg, MS 39401-7236 | 2007-05-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598315863 | Lisa Thornton | Technician | 18 Timberline Dr., Hattiesburg, MS 39401 | 2019-09-18 |
| 1548813637 | Caroline Estes Barnes | Counselor | Barnes, 8 App Slade Road, Hattiesburg, MS 39401 | 2019-07-18 |
| 1396252441 | Selection Healthcare Services, LLC | In Home Supportive Care | 606 Adeline St Ste 1c, Hattiesburg, MS 39401 | 2018-01-10 |
| 1225545585 | Whitney Wilkinson | Nurse Practitioner | 301 South 28th Avenue, Hattiesburg, MS 39401 | 2018-01-08 |
| 1740795806 | Forrest General Hospital | Pharmacy | 1414 South 28th Avenue, Hattiesburg, MS 39401 | 2017-12-11 |
| 1275058455 | Casey Payne | Pharmacist | 6130 Us 49, Hattiesburg, MS 39401 | 2017-08-08 |
| 1225562705 | Sarah Marie Hudson | Family Medicine | 6051 Us Highway 49 S, Hattiesburg, MS 39401 | 2017-04-12 |
| 1043671704 | The Covington's Cove Assisted Living Center LLC | Assisted Living Facility | 192 Mary Magdalene Church Rd, Hattiesburg, MS 39401 | 2016-03-09 |
| 1780083626 | Dominique Reed Watson | Pharmacist | 602 Adeline St, Hattiesburg, MS 39401 | 2014-08-15 |
| 1558778936 | Willie Davis Jr. | Day Training, Developmentally Disabled Services | 701 Duke Ave., Hattiesbiurg, MS 39401 | 2014-07-17 |
| Find all providers in zip 39401 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477601177 | Forrest County General Hospital | Pathology | 300 S 29th Ave, Hattiesburg, MS 39401-7127 | 2007-01-08 |
| 1487636379 | Delia A. Smith | Pathology | 5052 W 4th St, Hattiesburg, MS 39402-1069 | 2005-11-16 |
| 1609121557 | Usa Pathology Pllc | Pathology | 5052 W 4th St, Ste 3, Hattiesburg, MS 39402-1069 | 2012-07-17 |
| 1689993644 | Lynda Gentchev | Pathology | 5052 W 4th St, Hattiesburg, MS 39402-1069 | 2010-05-28 |
| 1518175314 | Hattiesburg Clinic, P.a. | Pathology | 421 S 28th Ave, Hattiesburg, MS 39401-7206 | 2007-05-18 |
| 1336351659 | Leigh Anne Strong | Pathology | 421 S 28th Ave, Hattiesburg, MS 39401-7236 | 2007-05-07 |
| 1922132323 | Thomas Edwards Carey | Pathology | 5052 W 4th St, Hattiesburg, MS 39402-1069 | 2007-03-15 |
| 1932218138 | Sue D Walker | Pathology | 421 S 28th Ave, Hattiesburg, MS 39401-7236 | 2006-08-30 |
| 1841308160 | Thomas G Puckett | Pathology | 421 S 28th Ave, Hattiesburg, MS 39401-7236 | 2006-08-27 |
| 1043324767 | Hub Care Pathology, P.a. | Pathology | 5052 W 4th St, Hattiesburg, MS 39402-1069 | 2006-08-18 |
| Find all providers in HATTIESBURG | ||||
| City | HATTIESBURG |
| Zip Code | 39401 |
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.