Individual
DONALD WAYNE WASHBURN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7601 SOUTHCREST PKWY, SOUTHAVEN, MS 38671-4739
(662) 772-4000
Mailing address
7601 SOUTHCREST PKWY, SOUTHAVEN, MS 38671-4739
(662) 772-4000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
MS
Other
Enumeration date
07/17/2014
Last updated
07/17/2014
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