EAR, NOSE & THROAT
NPI 1003905076
Otolaryngology in Hattiesburg, MS

Q: What is Hattiesburg Clinic PA's NPI number?

The NPI number for Hattiesburg Clinic PA is 1003905076. It was assigned to this organization in the NPPES registry on October 11, 2006. The provider is doing business as Ear, Nose & Throat.

Q: What is Hattiesburg Clinic PA's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Active since October 11, 2006CLIA Certified · 3 labs

1605 S 28TH AVE, HATTIESBURG, MS 39402(601) 264-5684(601) 264-0231 Get Directions Write a Review

NPPES record last updated: October 7, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Ear, Nose & Throat NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EAR, NOSE & THROAT (NPI 1003905076) is a healthcare organization registered as an otolaryngology in Hattiesburg, Mississippi and active in the NPI registry since October 2006. The organization holds 3 active CLIA laboratory certificates and lists Bryan N Batson, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1003905076

Entity TypeOrganization

Primary Taxonomy207Y00000X

Legal Business NameHATTIESBURG CLINIC PA

Location Address1605 S 28TH AVEHattiesburg, MS 39402-3110

Mailing Address415 S 28th AveHattiesburg, MS 39401-7246 · (601) 579-3310 · Fax (601) 264-0231

Phone(601) 264-5684

Fax(601) 264-0231

Organization SubpartNo

Authorized OfficialBryan N BatsonExecutive Director · (601) 268-5601

Enumeration DateOctober 11, 2006

Last NPPES UpdateOctober 7, 2020

NPPES CertifiedOctober 7, 2020

✔ NPI 1003905076 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians

Taxonomy Code207Y00000X

Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

1605 S 28TH AVE, Hattiesburg, MS 39402

Open in Google Maps ↗

Other Names 1

Doing Business AsEar, Nose & Throat

Other Identifiers 1

Medicaid04422066MS

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 4

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 25D2029926

Poc Hattiesburg Clinic Main Campus · Hattiesburg, MS

Active · expires Sep 15, 2027

CLIA Number25D2029926

Laboratory TypePhysician Office

Certificate Effective DateSeptember 16, 2025

Certificate Expiration DateSeptember 15, 2027

Laboratory DirectorDr. Andrew L. Dunn

Laboratory Phone(601) 579-3090

Laboratory LocationPoc Hattiesburg Clinic Main Campus415 S 28th Avenue, Hattiesburg, MS 39401

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Accreditation 25D0651923

Hattiesburg Clinic Dept Of Pathology · Hattiesburg, MS

Active · expires Apr 2, 2027

CLIA Number25D0651923

Laboratory TypeIndependent

Certificate Effective DateApril 3, 2025

Certificate Expiration DateApril 2, 2027

Laboratory DirectorDr. Andrew L. Dunn

Laboratory Phone(601) 579-5244

Laboratory LocationHattiesburg Clinic Dept Of Pathology421 South 28th Avenue Suite 310, Hattiesburg, MS 39401

CLIA data matches this NPI record on: Name

This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Compliance 25D2115030

Hattiesburg Clinic - Lake Serene · Hattiesburg, MS

Active · expires Oct 2, 2026

CLIA Number25D2115030

Laboratory TypePhysician Office

Certificate Effective DateOctober 3, 2024

Certificate Expiration DateOctober 2, 2026

Laboratory DirectorJohn G. Holland

Laboratory Phone(601) 261-1560

Laboratory LocationHattiesburg Clinic - Lake Serene6813 Hwy 98 West, Hattiesburg, MS 39402

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 25D0969267

Hattiesburg Clinic Hematology/Oncology Laboratory · Hattiesburg, MS

Expired · Jul 31, 2026

CLIA Number25D0969267

Laboratory TypePhysician Office

Certificate Effective DateAugust 1, 2024

Certificate Expiration DateJuly 31, 2026

Laboratory DirectorDr. James M. Herrington

Laboratory Phone(601) 261-1721

Laboratory LocationHattiesburg Clinic Hematology/Oncology Laboratory301 South 28th Avenue, Hattiesburg, MS 39401

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ZOE GORE AU.D.

Audiologist