# DAVID M. HEADLEY, M.D. PA

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

## Provider details

- **NPI number:** 1578627782
- **Authorized official:** MRS. JEZELLE L HEADLEY (OFFICE MANAGER)
- **Authorized official phone:** (601) 437-3323

## Contact information

- **Practice address:** 405 MARKET ST, PORT GIBSON, MS 39150-2024
- **Practice address phone:** (601) 437-3323
- **Practice address fax:** (601) 437-8499
- **Mailing address:** PO BOX 676, PORT GIBSON, MS 39150-0676
- **Mailing address phone:** (601) 437-3323
- **Mailing address fax:** (601) 437-8499

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 09133 | MS | Yes |

## Other

- **Enumeration date:** 12/21/2006
- **Last updated:** 10/15/2008