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Hattiesburg Clinic Pa
Sports Medicine (Preventive Medicine) Physician in Hattiesburg, Mississippi
NPI 1871674754

Hattiesburg Clinic Pa is a Sports Medicine (Preventive Medicine) Physician based in Hattiesburg, MS and is specialized in Sports Medicine. Hattiesburg Clinic Pa practices in Hattiesburg, MS. The NPI Number for Hattiesburg Clinic Pa is 1871674754 and holds a License No. (Mississippi).

The current practice location address for Hattiesburg Clinic Pa is 415 S 28Th Ave, Hattiesburg, MS and can be reached out via phone at 601-579-5406 and via fax at 601-268-5756.

Location: 415 S 28Th Ave, Hattiesburg, MS, 39401-7246
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1871674754
Provider Name
Hattiesburg Clinic Pa
Credential
Provider Entity Type
Organization
Address
415 S 28Th Ave, Hattiesburg, MS, 39401-7246
Phone Number
601-579-5406
Fax Number
601-268-5756
Provider Enumeration Date
10/18/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
06389072 05 MS
institution
Provider Business Practice Location Address Details
Address
415 S 28Th Ave
City
Hattiesburg
State
Mississippi
Zip
39401-7246
Phone Number
601-579-5406
Fax Number
601-268-5756
person
Provider Business Mailing Address Details
Address
415 S 28Th Ave
City
Hattiesburg
State
Mississippi
Zip
39401-7246
Phone Number
601-579-5406
Fax Number
601-268-5756
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Preventive Medicine
Speciality
Sports Medicine
Taxonomy
2083S0010X
License No.
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Definition
A preventive medicine physician who specializes in the diagnosis and treatment of sports related conditions and injuries.
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