Individual
MARTIN D HARVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
704 FIFTH STREET, COLLINS, MS 39428
(601) 765-4414
(601) 765-9141
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 765-4414
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14818
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00122271
—
MS
01
—
1559185
AMERICAN ADMIN GROUP
MS
Enumeration date
08/14/2006
Last updated
07/14/2020
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