Organization · Type 2 NPI
Oak Grove Longleaf
Federally Qualified Health Center (FQHC) · Hattiesburg, MS
NPI number
1053985226
Active · reactivated Jul 8, 2022
Practice location
5279 W 4th St
Hattiesburg, MS 39402-9700
Fax (601) 450-2493
Mailing address
PO Box 1729
Hattiesburg, MS 39403-1729
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Federally Qualified Health Center (FQHC) Primary | 261QF0400X | None listed |
Federally Qualified Health Center (FQHC): Definition to come...
Another provider at this address
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About NPI 1053985226
Oak Grove Longleaf's National Provider Identifier is 1053985226, issued on May 13, 2021. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Hattiesburg, MS. The record was last updated on Feb 5, 2026.