Provider Demographics
NPI:1730293234
Name:HATTIESBURG GI ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:HATTIESBURG GI ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUZETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-268-5185
Mailing Address - Street 1:100 METHODIST HOSPITAL BLVD
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-1295
Mailing Address - Country:US
Mailing Address - Phone:601-268-5185
Mailing Address - Fax:601-268-5006
Practice Address - Street 1:100 METHODIST HOSPITAL BLVD
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-1295
Practice Address - Country:US
Practice Address - Phone:601-268-5185
Practice Address - Fax:601-268-5006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09014857Medicaid
MSC02402Medicare ID - Type UnspecifiedGROUP NUMBER