Individual
DR. WILLIAM EARL GUSA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 NORTH STATE STREET, JACKSON, MS 39216-4500
(601) 815-1196
(601) 984-5939
Mailing address
2500 NORTH STATE STREET, JACKSON, MS 39216-4500
(601) 984-5936
(601) 984-5939
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
24076
MS
207LP2900X
Pain Medicine (Anesthesiology) Physician
MD052249L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014801510003
—
PA
01
—
P01620200
RAILROAD MEDICARE
MS
Enumeration date
07/28/2005
Last updated
04/26/2016
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