Individual
CATHERINE FAULK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-2195
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-2195
Taxonomy
Speciality
Code
Description
License number
State
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
15519
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00120599
—
MS
05
—
157389
—
AL
Enumeration date
09/22/2006
Last updated
04/01/2014
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