| Gastroenterology | |
|
415 S 28th Ave Hattiesburg MS 39401-7246 | |
| (601) 268-5680 | |
| (601) 268-5778 |
| Full Name | Gastroenterology |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 415 S 28th Ave, Hattiesburg, Mississippi |
| Authorized Official Name and Position | Bryan N Batson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6012646000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gastroenterology 415 S 28th Ave Hattiesburg MS 39401-7246 Ph: (601) 268-5680 | Gastroenterology 415 S 28th Ave Hattiesburg MS 39401-7246 Ph: (601) 268-5680 |
| NPI Number | 1497836308 |
|---|---|
| Provider Enumeration Date | 10/18/2006 |
| Last Update Date | 02/18/2021 |
| Certification Date | 02/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497836308 | NPI | - | NPPES |
| 06175873 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (NU) | Primary |
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