Individual
DR. JEREMY TODD JERNIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2045 E PASS RD STE B, GULFPORT, MS 39507-3761
(228) 896-7574
(228) 896-7579
Mailing address
2045 E PASS RD STE B, GULFPORT, MS 39507-3761
(228) 896-7574
(228) 896-7579
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1065
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
342005143
TAX IDENTIFICATION NUMBER
MS
Enumeration date
02/06/2007
Last updated
03/15/2023
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