Provider Demographics
NPI:1649444605
Name:DAVID M HALINSKI MD PC
Entity type:Organization
Organization Name:DAVID M HALINSKI MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:HALINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:601-636-9064
Mailing Address - Street 1:114 MONUMENT PL
Mailing Address - Street 2:SUITE B
Mailing Address - City:VICKSBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39180-5169
Mailing Address - Country:US
Mailing Address - Phone:601-636-9064
Mailing Address - Fax:601-636-9067
Practice Address - Street 1:114 MONUMENT PL
Practice Address - Street 2:SUITE B
Practice Address - City:VICKSBURG
Practice Address - State:MS
Practice Address - Zip Code:39180-5169
Practice Address - Country:US
Practice Address - Phone:601-636-9064
Practice Address - Fax:601-636-9067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-21
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS16067207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS07531006Medicaid
MS512G700397Medicare PIN
MS07531006Medicaid