Havens, Michael Randolph

Havens, Michael Randolph is an sole proprietor health care provider with primary practice located at 107 Eureka St , Batesville MS 38606-2533. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Havens, Michael Randolph can be contacted via phone (662) 563-6000.

Contact Information

Primary practice address
107 Eureka St Batesville MS 38606-2533
Fax: (662) 563-2200
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 11732 Mississippi

Profile Details

NPI number 1316928955
LBN Legal business name Havens, Michael Randolph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 10th, 2005
Last updated Jul 26th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316928955 NPPES
Mississippi MEDICAID 00115542

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