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Individual

EDWIN P HARMON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 925-6805
(601) 926-4978
Mailing address
PO BOX 24146, JACKSON, MS 39225-4146
(601) 925-6723
(601) 926-4978

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4774
AK
2088P0231X
Pediatric Urology Physician
Primary
06918
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00017183
MS
05
MD4774
AK
Enumeration date
06/09/2006
Last updated
07/24/2012
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