Individual
LUCETTE LIDDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1000
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
T-4844
MS
Other
Enumeration date
06/05/2016
Last updated
06/15/2024
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