Individual
CHARLES MITCHELL HOLLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
509 BROOKMAN DR, BROOKHAVEN, MS 39601-2326
(601) 823-5204
(601) 833-1224
Mailing address
509 BROOKMAN DR, BROOKHAVEN, MS 39601-2326
(601) 823-5204
(601) 833-1224
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
11043
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115067
—
MS
Enumeration date
07/25/2006
Last updated
10/25/2016
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