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
Phone: (662) 563-6000
Fax: (662) 563-2200
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316928955 | NPPES |
| Mississippi | MEDICAID | 00115542 |
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