Individual
MR. GAVIN W NOWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1225 N STATE ST, JACKSON, MS 39202-2064
(601) 968-1700
Mailing address
PO BOX 16076, JACKSON, MS 39236-6076
(601) 936-6001
(601) 936-4389
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
01/28/2014
Last updated
01/28/2014
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