institution
Hattiesburg Clinic, Pa
End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Tylertown, Mississippi
NPI 1821021155

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 Tylertown, MS. The NPI Number for Hattiesburg Clinic, Pa is 1821021155 and holds a License No. (Mississippi).

The current practice location address for Hattiesburg Clinic, Pa is 4820 Plaza Dr, Tylertown, MS and can be reached out via phone at 601-222-0311 and via fax at 601-222-0351.

Location: 4820 Plaza Dr, Tylertown, MS, 39401-7246
institution
Provider Profile Details
NPI Number
1821021155
Provider Name
Hattiesburg Clinic, Pa
Credential
Provider Entity Type
Organization
Address
4820 Plaza Dr, Tylertown, MS, 39401-7246
Phone Number
601-222-0311
Fax Number
601-222-0351
Provider Enumeration Date
07/09/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
5000477 01 MS UNITED HEALTHCARE
00220570 05 MS
000050656 01 MS BLUE CROSS BLUE SHIELD MS
institution
Provider Business Practice Location Address Details
Address
4820 Plaza Dr
City
State
Zip
39667-9221
Phone Number
601-222-0311
Fax Number
601-222-0351
person
Provider Business Mailing Address Details
Address
4820 Plaza Dr
City
State
Zip
39667-9221
Phone Number
601-222-0311
Fax Number
601-222-0351
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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