Organization
EAST LAKELAND OB GYN ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BEVERLY ANN MCMILLAN M.D. (PRESIDENT)
(601) 936-1400
Entity
Organization
Contact information
Practice address
1020 RIVER OAKS DR, SUITE 320, JACKSON, MS 39232-9500
(601) 936-1400
(601) 936-0671
Mailing address
1020 RIVER OAKS DR, SUITE 320, JACKSON, MS 39232-9500
(601) 936-1400
(601) 936-0671
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9013604
—
MS
Enumeration date
09/27/2006
Last updated
05/27/2008
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