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General NPI Number Information
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NPI Number | 1427108729
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Entity Type | Organization
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Legal Business Name | BROOKHAVEN OB-GYN ASSOCIATES, PA
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 11/09/2010
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Provider Practice Location Address
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Address Line | 1012 D A BIGLANE DR
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City | BROOKHAVEN
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State | MS
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Zip | 39601-2331
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Country | US
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Telephone | 601-833-8157
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Fax | 601-833-1633
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Provider Business Mailing Address
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Address Line | 1012 D A BIGLANE DR
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City | BROOKHAVEN
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State | MS
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Zip | 39601-2331
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Country | US
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Telephone | 601-833-8157
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Fax | 601-833-1633
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEVE MILLS
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Credential | M.D.
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Telephone | 601-833-8157
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 207V00000X
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License Number State | MS
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