Individual
COLE SHANE CRAIGHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-8010
Mailing address
710 COUNTRY PLACE DR, PEARL, MS 39208-6664
(318) 450-0092
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/02/2020
Last updated
04/02/2020
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