| Hattiesburg Clinic Pa | |
|
2013 North Pine Heidelberg MS 39439 | |
| (601) 787-2337 | |
| (601) 787-2347 |
| Full Name | Hattiesburg Clinic Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 2013 North Pine, Heidelberg, 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 |
|---|---|
| Hattiesburg Clinic Pa 415 S 28th Ave Hattiesburg MS 39401-7246 Ph: (601) 579-5488 | Hattiesburg Clinic Pa 2013 North Pine Heidelberg MS 39439 Ph: (601) 787-2337 |
| NPI Number | 1417046574 |
|---|---|
| Provider Enumeration Date | 10/12/2006 |
| Last Update Date | 02/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417046574 | NPI | - | NPPES |
| 09016201 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Jfmc Heidelberg, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1208 Academy Dr, Heidelberg, MS 39439 Phone: 601-787-4906 Fax: 601-787-4909 |