Individual
MIA NICOLE FURGURSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1000
Mailing address
761 RICE RD APT 815, RIDGELAND, MS 39157-1092
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
T-5899
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/04/2025
Last updated
07/17/2025
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