MR. HOLLAND J PITRE (NPI# 1467418152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467418152 |
| Entity Type | Individual |
| Full Name | MR. HOLLAND J PITRE |
| Credential | MD |
| Practice Address |
1202 Mission Park Dr 1202 Mission Park Dr Vicksburg MS 39180-3758 |
| Practice Telephone | 6014156089 |
| Practice Fax Number | 6016366677 |
| Mailing Telephone | 6014156089 |
| Mailing Fax Number | 6016366677 |
| Enumeration Date | 2006-04-22 |
| Last Update Date | 2013-08-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 12026 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1095303 | 05 | |
| MS | PTAN | 3021079461 | 01 |
| Street Address |
1202 MISSION PARK DR 1202 MISSION PARK DR |
| City | VICKSBURG |
| State | MS |
| Zip Code | 39180-3758 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598819450 | Dermatology and Skin Cancer Clinic, P.a. | Specialist | 1202 Mission Park Dr, Vicksburg, MS 39180-3758 | 2007-01-22 |
| 1962411215 | Dawinder Singh Sohal | Internal Medicine | 1202 Mission Park Dr, Vicksburg, MS 39180-3758 | 2006-08-05 |
| 1023068350 | Wayne Michael Pitre | Specialist | 1202 Mission Park Dr, Vicksburg, MS 39180-3758 | 2006-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255877346 | Elite Performance and Rehab, LLC | Clinic/Center | 1901 A Mission 66, Vicksburg, MS 39180 | 2017-01-12 |
| 1679931083 | Heather M Anderson | Physician Assistant | 2080 S Frontage Rd Ste 100, Vicksburg, MS 39180 | 2016-02-01 |
| 1245604941 | Warren County Assn.for Retarded Citizens, Inc. | Day Training, Developmentally Disabled Services | 100 Smokey Lane, Vicksburg, MS 39180 | 2015-11-18 |
| 1386012904 | Brian Oliver Snowden | Counselor | 3530 Manor Dr Ste 5a, Vicksburg, MS 39180 | 2015-09-14 |
| 1962802710 | Jordan P. Crocker, D.m.d., Pllc | Clinic/Center | 109 Monument Place, Vicksburg, MS 39180 | 2014-08-29 |
| 1821434259 | Trisha Addison | Physical Therapist | 2222 South Frontage Road, Suite D, Vicksburg, MS 39180 | 2013-05-13 |
| 1073862157 | Laura Jeanne Briggs | Physical Therapist | 1901-a Mission 66, Vicksburg, MS 39180 | 2012-09-05 |
| 1912175258 | Andrea T. Harris | Counselor | Warren-yazoo Mental Health Service, 3444 Wisconsin Ave., Vicksburg, MS 39180 | 2008-02-20 |
| 1922217314 | Austin Family Dentistry | Dentist | 3040 Indiana Ave, Vicksburg, MS 39180 | 2007-05-22 |
| 1063539138 | Ollie Hardaway Jr. | Dentist | 154 Cottonwood Street, Vicksburg, MS 39180 | 2007-03-23 |
| Find all providers in zip 39180 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265729719 | Jasmine C. Hollinger | Dermatology | 2080 S Frontage Rd Ste 113, Vicksburg, MS 39180-5882 | 2011-07-06 |
| 1245868801 | Integrative Skin Care of Mississippi | Dermatology | 2080 S Frontage Rd Ste 113, Vicksburg, MS 39180-5882 | 2020-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760043046 | Skin In The Game, Pllc | Dermatology | 6510 Highway 90, Gautier, MS 39553-5015 | 2019-06-26 |
| 1427535079 | Jenna Joe Rose Cooper | Dermatology | 2204 Jefferson Davis Dr, Oxford, MS 38655-5222 | 2018-07-26 |
| 1427460849 | Anna Allred Wile | Dermatology | 4331 Highway 39 N Ste A, Meridian, MS 39301-1007 | 2014-05-21 |
| 1134558331 | South Central Clinics, Inc | Dermatology | 920 Matthew Dr Ste 8, Waynesboro, MS 39367-2553 | 2013-11-07 |
| 1407296825 | Ashley Nicole Emerson | Dermatology | 6510 Highway 90 Ste C, Gautier, MS 39553-5015 | 2013-06-29 |
| 1295022861 | Kenneth Daniel Saul | Dermatology | 5002 Highway 39 N Bldg A, Meridian, MS 39301-1078 | 2011-07-05 |
| 1689969735 | Adam C Byrd | Dermatology | 313 N Court Ave, Ummc Dermatology - Louisville Clinic, Louisville, MS 39339 | 2011-06-16 |
| 1063724987 | Lyndsay R Shipp | Dermatology | 705 Sisk Ave Ste 105, Oxford, MS 38655-3413 | 2010-07-08 |
| 1144545195 | Lisa Renee Chastant | Dermatology | 81 Mdos/sgomd, 301 Fisher St., Keesler Afb, MS 39534-2519 | 2010-04-01 |
| 1982836037 | Bethany R Hairston Md | Dermatology | 724 Leigh Drive, Columbus, MS 39705-3098 | 2009-08-21 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.