Individual
MARY JORDAN MELANCON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1000
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
T-5784
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2025
Last updated
07/02/2025
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