MEDICARE: J.C. PASSMAN MDPA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT0333	MS
2	204C00000X	Sports Medicine (Neuromusculoskeletal Medicine) Physician	05227	MS

General Provider Information

NPI Number	:	1083643761
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J.C. PASSMAN MDPA

Provider Business Mailing Address
First Line	:	46 SGT PRENTISS DR
Second Line	:	SUITE 103
City	:	NATCHEZ
State	:	MS
Zip	:	39120-4792
Country	:	US
Telephone Number	:	601-442-9654
Fax Number	:	601-442-9790

Provider Business Practice Location Address
First Line	:	46 SGT PRENTISS DR
Second Line	:	SUITE 103
City	:	NATCHEZ
State	:	MS
Zip	:	39120-4792
Country	:	US
Telephone Number	:	601-442-9654
Fax Number	:	601-442-9790

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT BRIAN HAIMSON
Credential	:	MD
Telephone Number	:	601-442-9654

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	09/16/2009

Similar Medicare Providers

1295730224 — DR. THOMAS BRADFORD LEMAY M.D.
Practice Location Address:

46 SGT PRENTISS DR , SUITE 204, NATCHEZ REGIONAL MEDICAL OFFICE BUILDING
NATCHEZ, MS
39120-4792

Practice Phone: 601-653-4927
Practice Fax: 601-897-0542

1568491231 — MRS. MARCIA HUBBARD PASSMAN RPT
Practice Location Address:

46 SGT PRENTISS DR , SUITE 103
NATCHEZ, MS
39120-4792

Practice Phone: 601-442-9654
Practice Fax: 601-442-9790

1245260900 — NATCHEZ REGIONAL MEDICAL CENTER
Practice Location Address:

46 SGT PRENTISS DR , SUITE 202
NATCHEZ, MS
39120-4792

Practice Phone: 601-443-2100
Practice Fax: 601-443-2885

1902838162 — MR. STACY WAYNE DENNIS PA-C
Practice Location Address:

46 SGT PRENTISS DR , SUITE 103
NATCHEZ, MS
39120-4792

Practice Phone: 601-442-9654
Practice Fax: 601-442-9790

1851326813 — JEFFREY ROSS ANDERSON D.O.
Practice Location Address:

300 HIGHLAND BLVD , SUITE C
NATCHEZ, MS
39120-4792

Practice Phone: 601-442-4343
Practice Fax: 601-442-4311

1740215797 — SCOTT JAY WOLFE M.D.
Practice Location Address:

46 SEARGENT S. PRENTISS DR , SUITE 203
NATCHEZ, MS
39120-4792

Practice Phone: 601-445-7773
Practice Fax: 601-445-5911

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