Individual
OMKAR HEMANT DAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1325 E FORTIFICATION ST, JACKSON, MS 39202-2442
(601) 949-9106
(601) 914-1835
Mailing address
1325 E FORTIFICATION ST, JACKSON, MS 39202-2442
(601) 949-9106
(601) 914-1835
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
0034792
TX
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
23122
MS
Other
Enumeration date
04/24/2009
Last updated
06/30/2014
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