Organization · Type 2 NPI

Hattiesburg Clinic PA

Family Medicine Physician · Heidelberg, MS

NPI number 1417046574 Active

Practice location

2013 North Pine
Heidelberg, MS 39439

Call (601) 787-2337 Map

Fax (601) 787-2347

Mailing address

415 S 28th Ave
Hattiesburg, MS 39401-7246

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	None listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

NPI record

NPI: 1417046574
Entity type: Organization (Type 2)
Issued: Oct 12, 2006
Last updated: Feb 18, 2021
Status: Active

Other names

<unavail>
Heidelberg Medical Clinic · doing business as
Heidelberg Medical Clinic · doing business as

Authorized official

Bryan N Batson
Executive Director
(601) 264-6000

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1417046574

Hattiesburg Clinic PA's National Provider Identifier is 1417046574, issued on Oct 12, 2006. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Heidelberg, MS. The record was last updated on Feb 18, 2021.