# J.C. PASSMAN MDPA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083643761
- **Authorized official:** DR. ROBERT BRIAN HAIMSON MD (PRESIDENT)
- **Authorized official phone:** (601) 442-9654

## Contact information

- **Practice address:** 46 SGT PRENTISS DR, SUITE 103, NATCHEZ, MS 39120-4792
- **Practice address phone:** (601) 442-9654
- **Practice address fax:** (601) 442-9790
- **Mailing address:** 46 SGT PRENTISS DR, SUITE 103, NATCHEZ, MS 39120-4792
- **Mailing address phone:** (601) 442-9654
- **Mailing address fax:** (601) 442-9790

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204C00000X | Sports Medicine (Neuromusculoskeletal Medicine) Physician | 05227 | MS | Yes |
| 225100000X | Physical Therapist | PT0333 | MS | — |

## Other

- **Enumeration date:** 07/03/2006
- **Last updated:** 09/16/2009