Individual
MANASA GUNTURU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216
(601) 984-5500
Mailing address
2500 N STATE ST, CBO-SUITE 4200, JACKSON, MS 39216-4500
(601) 984-5500
Taxonomy
Speciality
Code
Description
License number
State
207WX0109X
Neuro-ophthalmology Physician
26620
MS
2084N0400X
Neurology Physician
Primary
26620
MS
2084N0400X
Neurology Physician
910-L
MS
Other
Enumeration date
06/17/2014
Last updated
04/24/2020
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