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Physicians Internal Medicine Critical Care Medicine

Provider NPI: 1437312915

Provider Information:
Gender: M
Not Sole Proprietor

Practice Location:
1200 N STATE ST SUITE 480 JACKSON, MS 39202-2000 US
Tel: 601-352-2273  Fax: 601-714-3415

Business Mailing Address:
971 LAKELAND DR STE 1052 JACKSON, MS 39216-4609 US
Tel: 601-206-6100  Fax: 601-206-6052

NPI Information:
NPI: 1437312915
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Internal Medicine
Critical Care Medicine
Internal Medicine

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 207RP1001X





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