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Individual

ANDREW DENNIS PARENT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5706
(601) 984-6491
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5706
(601) 984-6491

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
08228
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00016928
MS
01
08228
STATE LICENSE
MS
01
140000084
2007 MCR
MS
01
142945605
RR PTAN
MS
Enumeration date
05/28/2006
Last updated
05/12/2015
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