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

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

601 Brookman Dr Ext
#A
Brookhaven, MS 39601
Phone (601) 823-5275

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician
Group: 193400000X SINGLE SPECIALTY GROUP
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

Other providers in Brookhaven, MS

All providers in Brookhaven, MS · Pediatrics Physician in Mississippi

Sources for this page

Verify at the official NPI Registry.