Individual
JEFFERSON BUNTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
N.P.
Contact information
Practice address
146 HIGHLAND PKWY, PICAYUNE, MS 39466-5575
(601) 358-9765
Mailing address
146 HIGHLAND PKWY, PICAYUNE, MS 39466-5575
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
R881222
MS
Other
Enumeration date
02/09/2015
Last updated
02/09/2015
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