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Individual

DR. KEVIN MARK PASSER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5317-4 OLD HIGHWAY 11, HATTIESBURG, MS 39402
(601) 261-9101
(601) 261-9102
Mailing address
6068 HIGHWAY 98 WEST, SUITE 1-255, HATTIESBURG, MS 39402
(601) 261-9101
(601) 261-9102

Taxonomy

Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
13970
MS
2084P0800X
Psychiatry Physician
Primary
13970
MS

Other

Enumeration date
08/04/2006
Last updated
11/02/2012
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