Organization
JULIE WYATT DERMATOLOGY CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE P WYATT MD (OWNER)
(601) 982-5441
Entity
Organization
Contact information
Practice address
3000 OLD CANTON RD STE 430, JACKSON, MS 39216-4225
(601) 982-5441
(601) 982-5442
Mailing address
3000 OLD CANTON RD STE 430, JACKSON, MS 39216-4225
(601) 982-5441
(601) 982-5442
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
20645
MS
Other
Enumeration date
09/04/2018
Last updated
09/04/2018
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