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Individual

SARA HANAK GLEASON

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) 984-5815
(601) 984-5842
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5815
(601) 984-5842

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
19946
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09375393
MS
05
196519
MS
Enumeration date
06/22/2007
Last updated
04/19/2017
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