Individual
DR. JONATHAN J POLHEMUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1220 JEFFERSON ST, LAUREL, MS 39440-4355
(601) 426-4507
(601) 426-4228
Mailing address
PO BOX 247, LAUREL, MS 39441-0247
(601) 426-4507
(601) 426-4228
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MS19391
MS
Other
Enumeration date
07/31/2006
Last updated
12/26/2007
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