Individual
DR. OMAR HASAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2500 N STATE ST # N408, JACKSON, MS 39216-4500
(601) 984-2828
Mailing address
4639 KIRKLEY DR, JACKSON, MS 39206-3301
(210) 965-7501
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
ME160204
FL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
T-5146
MS
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/18/2019
Last updated
07/10/2023
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