Organization · Type 2 NPI
Hattiesburg Clinic, PA
End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Tylertown, MS
NPI number
1821021155
Active
Practice location
4820 Plaza Dr
Tylertown, MS 39667-9221
Fax (601) 222-0351
Mailing address
415 S 28th Ave
Hattiesburg, MS 39401-7246
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary | 261QE0700X | None listed |
End-Stage Renal Disease (ESRD) Treatment Clinic/Center: Definition to come...
About NPI 1821021155
Hattiesburg Clinic, PA's National Provider Identifier is 1821021155, issued on Jul 9, 2006. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Tylertown, MS. The record was last updated on Feb 22, 2021.