Individual
DR. JUAN DIEGO URIBE VILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, DEPT. OF NEUROSURGERY, JACKSON, MS 39216-4500
(601) 984-5700
Mailing address
2500 N STATE ST, JMM ROOM 2525, JACKSON, MS 39216-4500
(601) 984-6426
(601) 984-6439
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
23837
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02700811
—
MS
Enumeration date
08/15/2009
Last updated
09/15/2016
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