# JENNIFER D GHOLSON MD, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487967410
- **Authorized official:** DR. JENNIFER GHOLSON MD (OWNER)
- **Authorized official phone:** (601) 276-7665

## Contact information

- **Practice address:** 804 ROBB ST, SUMMIT, MS 39666-8291
- **Practice address phone:** (601) 276-7665
- **Practice address fax:** (601) 276-7655
- **Mailing address:** 804 ROBB ST, SUMMIT, MS 39666-8291
- **Mailing address phone:** (601) 276-7665
- **Mailing address fax:** (601) 276-7655

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/19/2010
- **Last updated:** 06/16/2015