institution
Hattiesburg Clinic, Pa
End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Laurel, Mississippi
NPI 1245263540

Hattiesburg Clinic, Pa is a End-Stage Renal Disease (ESRD) Treatment Clinic/Center based in Hattiesburg, MS and is specialized in End-Stage Renal Disease (ESRD) Treatment. Hattiesburg Clinic, Pa practices in Laurel, MS. The NPI Number for Hattiesburg Clinic, Pa is 1245263540 and holds a License No. (Mississippi).

The current practice location address for Hattiesburg Clinic, Pa is 1527 Larry Dr, Laurel, MS and can be reached out via phone at 601-425-1853 and via fax at 601-425-1877. You can also correspond with Hattiesburg Clinic, Pa through the mailing address at 415 S 28TH AVE, HATTIESBURG, MS - 39401-7246 (mailing address contact number: 601-425-1853).

Location: 1527 Larry Dr, Laurel, MS, 39401-7246
institution
Provider Profile Details
NPI Number
1245263540
Provider Name
Hattiesburg Clinic, Pa
Credential
Provider Entity Type
Organization
Address
1527 Larry Dr, Laurel, MS, 39401-7246
Phone Number
601-425-1853
Fax Number
601-425-1877
Provider Enumeration Date
07/09/2006
Last Update Date
03/08/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
00020338 05 MS
000050273 01 MS BLUE CROSS BLUE SHIELD MS
5000477 01 MS UNITED HEALTHCARE
institution
Provider Business Practice Location Address Details
Address
1527 Larry Dr
City
State
Zip
39440-1932
Phone Number
601-425-1853
Fax Number
601-425-1877
person
Provider Business Mailing Address Details
Address
415 S 28Th Ave
City
State
Zip
39401-7246
Phone Number
601-425-1853
Fax Number
601-425-1877
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
End-Stage Renal Disease (ESRD) Treatment
Taxonomy
License No.
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Definition
Definition to come...
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