Basic Information
| Provider Information | |||||||||
| NPI: | 1679890552 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HARDEN | ||||||||
| FirstName: | BAHATI | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1401 RIVER RD | ||||||||
| Address2: | P.O. BOX 1410 | ||||||||
| City: | GREENWOOD | ||||||||
| State: | MS | ||||||||
| PostalCode: | 389304030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6624597285 | ||||||||
| FaxNumber: | 6624591147 | ||||||||
| Practice Location | |||||||||
| Address1: | 102 PROFESSIONAL PL | ||||||||
| Address2: | |||||||||
| City: | GREENWOOD | ||||||||
| State: | MS | ||||||||
| PostalCode: | 389309633 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6624517881 | ||||||||
| FaxNumber: | 6624517865 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/30/2010 | ||||||||
| LastUpdateDate: | 03/25/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD205764 | LA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 22836 | MS | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.