Individual
JANICE LAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-6426
(601) 984-6439
Mailing address
PO BOX 11407, DEPT #2130, BIRMINGHAM, AL 35246-2130
(601) 925-6805
(601) 926-4971
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
21379
SC
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
22481
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08129845
—
MS
05
—
T55696
—
SC
Enumeration date
07/23/2006
Last updated
07/24/2013
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