Individual
MR. MILTON LAVELL WOODALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
1706 W 12TH ST, LAUREL, MS 39440-2559
(601) 369-2028
Mailing address
1706 W 12TH ST, LAUREL, MS 39440-2559
(601) 369-2028
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
906087
MS
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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