Individual
MRS. MARY FASER LOVERTICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1200 N STATE ST STE 270, JACKSON, MS 39202-2027
(601) 714-6470
Mailing address
965 RIDGE LAKE BLVD STE 315, MEMPHIS, TN 38120-9401
(901) 227-7015
(901) 227-8591
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA00793
MS
Other
Enumeration date
04/04/2024
Last updated
04/12/2024
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