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Organization
J.C. PASSMAN MDPA
Active
Organization
J.C. PASSMAN MDPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT BRIAN HAIMSON MD (PRESIDENT)
(601) 442-9654
Entity
Organization
Contact information
Practice address
46 SGT PRENTISS DR, SUITE 103, NATCHEZ, MS 39120-4792
(601) 442-9654
(601) 442-9790
Mailing address
46 SGT PRENTISS DR, SUITE 103, NATCHEZ, MS 39120-4792
(601) 442-9654
(601) 442-9790
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
05227
MS
225100000X
Physical Therapist
PT0333
MS
Other
Enumeration date
07/03/2006
Last updated
09/16/2009
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