Individual
MISS DALLAS MICHELLE THOMASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1907 MISSION 66, VICKSBURG, MS 39180-3711
(601) 636-1173
(601) 638-8287
Mailing address
1907 MISSION 66, VICKSBURG, MS 39180-3711
(601) 636-1173
(601) 638-8287
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00142
MS
Other
Enumeration date
09/15/2009
Last updated
03/25/2014
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