Individual
MITZI GAIL FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1991 LAKELAND DR STE C, JACKSON, MS 39216-5000
(601) 981-5887
Mailing address
PO BOX 5569, PEARL, MS 39288-5569
(601) 981-5887
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
09298
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00122986
—
MS
Enumeration date
10/27/2006
Last updated
07/08/2007
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