Individual
STUART P LEVENTHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
123 MCCOMB AVE, PORT GIBSON, MS 39150-2915
(601) 437-5141
Mailing address
PO BOX 320863, FLOWOOD, MS 39232-0863
(601) 919-6590
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19158
MS
Other
Enumeration date
08/05/2006
Last updated
07/08/2007
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