Individual
DR. JOHN BRADFORD INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5211
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5211
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
20177
MS
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
20177
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08888868
—
MS
Enumeration date
07/31/2007
Last updated
02/04/2014
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