Hattiesburg Clinic Pa

NPI 1770672768

Information of Hattiesburg Clinic Pa

The NPI 1770672768 is an Organization type. NPI No 1770672768 belongs to Hattiesburg Clinic Pa. Hattiesburg Clinic Pa specializes in Dermatopathology. is practising at 421 S 28th Ave, Hattiesburg, Mississippi 39401. You can also contact him via phone number (601) 579-5261.

Practice address located

  • 421 S 28th Ave
  • Hattiesburg, Mississippi 39401
  • (601) 579-5261
  • (601) 579-5261

Mailling address located

  • 415 S 28th Ave
  • Hattiesburg, Mississippi 39401
  • (601) 579-5261
  • (601) 579-5257
NPI No 1770672768
Primary Taxonomy
Authorized Official
Specialty of the provider
PrimaryTaxonomy CodeClassificationLicense NumberLicense State
No207ZD0900XDermatopathologyn/an/a
Yes207ZP0102XAnatomic Pathology & Clinical Pathologyn/an/a
Identifier for this provider
StateIdentifierTypeIssuer
MS08722873Medicaidn/a
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