HATTIESBURG CLINIC PA (NPI# 1972690287) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972690287 |
| Entity Type | Organization |
| Organization Name | HATTIESBURG CLINIC PA |
| Other Organization Name | OPHTHALMOLOGY - LAUREL |
| Practice Address |
321 S 11th Ave Laurel MS 39440-4316 |
| Mailing Address |
415 S 28th Ave Hattiesburg MS 39401-7246 |
| Practice Telephone | 6016492341 |
| Mailing Telephone | 6015795463 |
| Mailing Fax Number | 6015795240 |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2015-03-31 |
| 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 | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 05336300 | 05 |
| Other Name | Type Code |
|---|---|
| Ophthalmology - Laurel | 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 |
| 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 |
| 1720188030 | Hattiesburg Clinic Pa | Family Medicine | 7148 Us Highway 98, Suite101, Hattiesburg, MS 39402-8446 | 2006-09-25 |
| Street Address |
321 S 11TH AVE |
| City | LAUREL |
| State | MS |
| Zip Code | 39440-4316 |
| 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 | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558848747 | Advanced Glaucoma Eyecare | Ophthalmology | 8101 Sandy Spring Rd Ste 105, Laurel, MD 20707-3596 | 2018-07-20 |
| 1104010792 | Pamela D'souza-david | Ophthalmology | 8101 Sandy Spring Rd Ste 108, Laurel, MD 20707-3596 | 2007-08-28 |
| 1780889923 | Hattiesburg Eye Clinic, Pa | Ophthalmology | 1431 North 10th St, Suite 1, Laurel, MS 39440 | 2007-06-18 |
| 1225142458 | Eric Everett Lindstrom | Ophthalmology | 1020 Adams St, Laurel, MS 39440-4365 | 2006-08-17 |
| 1770532400 | Nancy Josette Ronsheim | Ophthalmology | 8311 Cherry Ln, Laurel, MD 20707-4830 | 2006-05-09 |
| 1790785145 | Diane H Lubkeman | Ophthalmology | 116 E Front St, Ste A, Laurel, DE 19956-1722 | 2005-07-28 |
| 1194144386 | Sarah Duhon Queck | Ophthalmology | 1020 Adams St, Laurel, MS 39440 | 2014-04-15 |
| 1083846075 | Nancy J Ronsheim, Md, Pa | Ophthalmology | 8311 Cherry Ln, Laurel, MD 20707-4830 | 2009-08-10 |
| 1114157666 | Eye Care and Surgery Pa | Ophthalmology | 8311 Cherry Ln, Laurel, MD 20707-4830 | 2009-07-17 |
| 1780812941 | Jeffrey Y.h. Chung, L.L.C. | Ophthalmology | 14201 Laurel Park Dr, Suite 104, Laurel, MD 20707-5203 | 2009-06-26 |
| Find all providers in LAUREL | ||||
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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.