Individual
STEVEN WILSON CABELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
427 HIGHWAY 51 N, BROOKHAVEN, MS 39601-2350
(800) 893-9698
Mailing address
4230 SUMMERTON DR, JACKSON, MS 39272-8738
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R857889
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01222596
—
MS
01
—
512I500576
MEDICARE PTAN#
MS
Enumeration date
05/04/2006
Last updated
11/21/2008
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