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HATTIESBURG CLINIC, PA
NPI 1720821861
Dermatology in Petal, MS

Active since June 17, 2024CLIA 25D0662435 · Certificate of Compliance
50 PARKWAY LN STE 250, PETAL, MS 39465(601) 544-0769 Get Directions Write a Review

NPPES record last updated: June 17, 2024. Verified against the NPPES registry weekly; last sync: September 27, 2026.

About Hattiesburg Clinic, Pa NPPES

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

HATTIESBURG CLINIC, PA (NPI 1720821861), doing business as Dermatology-petal, is a healthcare organization registered as a dermatology in Petal, Mississippi and active in the NPI registry since June 2024. The organization holds a CLIA Certificate of Compliance certificate valid through September 7, 2027 and lists Bryan N Batson, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1720821861
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameHATTIESBURG CLINIC, PA
Location Address50 PARKWAY LN STE 250Petal, MS 39465-3035
Mailing Address415 S 28th AveHattiesburg, MS 39401-7246 · (601) 264-6000
Phone(601) 544-0769
Organization SubpartNo
Authorized OfficialBryan N BatsonExecutive Director · (601) 268-6000
Enumeration DateJune 17, 2024
NPPES CertifiedJune 17, 2024
✔ NPI 1720821861 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
50 PARKWAY LN STE 250, Petal, MS 39465
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Other Names 1

Doing Business AsDermatology-petal

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL).Insurance ›

CLIA Laboratory Certificates CMS CLIA

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 Compliance 25D0662435

Hattiesburg Clinic - Ob-Gyn Lab · Hattiesburg, MS
Active · expires Sep 7, 2027
CLIA Number25D0662435
Laboratory TypeCommunity Clinic
Certificate Effective DateSeptember 8, 2025
Certificate Expiration DateSeptember 7, 2027
Laboratory DirectorJohn G. Holland III
Laboratory Phone(601) 268-6000
Laboratory LocationHattiesburg Clinic - Ob-Gyn Lab421 South 28th Avenue, Hattiesburg, MS 39401
CLIA data matches this NPI record on: Name Phone
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

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

HANNAH ROBERTS BADON
Dermatology
50 PARKWAY LN STE 250
PETAL, MS 39465
Forrest County (601) 544-0769

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Hattiesburg Clinic, PA's NPI number?

The NPI number for Hattiesburg Clinic, PA is 1720821861. It was assigned to this organization in the NPPES registry on June 17, 2024. The provider is doing business as Dermatology-Petal.

Where is Hattiesburg Clinic, PA located?

Hattiesburg Clinic, PA is located at 50 Parkway Ln Ste 250, Petal, MS 39465. The listed phone number is (601) 544-0769.

What is Hattiesburg Clinic, PA's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Hattiesburg Clinic, PA hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 25D0662435) is associated with this NPI, valid through September 7, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Hattiesburg Clinic, PA accept?

Health plans from Florida Blue (BlueCross BlueShield FL) list Hattiesburg Clinic, PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Hattiesburg Clinic, PA was last updated on June 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.