Individual
DR. MARY MORGAN MCLEOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-2940
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-2940
Taxonomy
Speciality
Code
Description
License number
State
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
Primary
23896
MS
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
T-2573
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07305711
—
MS
01
—
T-2573
TEMPORARY MEDICAL LICENSE NUMBER
MS
Enumeration date
06/29/2012
Last updated
07/06/2016
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