Brookhaven Children'S Clinic
Organization Active NPI Pediatrics Physician · Brookhaven, MS
NPI 1003928672 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1003928672
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 11043 (MS)
- Legal business name
- BROOKHAVEN CHILDREN'S CLINIC
- Practice address
- 624 Highway 51 N
Brookhaven, MS 39601-2337 - Phone
- (601) 835-2100
- Fax
- (601) 835-0451
- NPI assigned
- Aug 31, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Charles M Holland, M.D.
- Title
- Owner
- Phone
- (601) 835-2100
Practitioners 2
-
David Steven Braden, M.D.
-
Charles Mitchell Holland, M.D.
National Provider Directory
Locations
601 Brookman Dr Ext
#A
Brookhaven, MS 39601
Phone (601) 823-5275
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician |
208000000X | 11043 | MS | Yes |
Addresses
Primary practice location
624 Highway 51 N
Brookhaven, MS 39601-2337
Mailing address
624 Highway 51 N
Brookhaven, MS 39601-2337
Phone (601) 835-2100
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All providers in Brookhaven, MS · Pediatrics Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.