Holder, Michael Gordon

Holder, Michael Gordon is an individual health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine. Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine is his primary health care specialty. Holder, Michael Gordon can be contacted via phone (601) 984-2195.

Contact Information

Primary practice address
2500 N State St Jackson MS 39216-4500
Phone: (601) 984-2195
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 56873 Tennessee
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 2080P0204X 35-085978 Ohio
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 2080P0204X 24022 Mississippi
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 207PP0204X 17601 Nevada

Profile Details

NPI number 1821016031
LBN Legal business name Holder, Michael Gordon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2006
Last updated Mar 22nd, 2018 - about 8 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 1821016031 NPPES
Mississippi MEDICAID 04179262

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