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Individual

TAMARA GLENN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2500 N STATE ST, UMMC DEPARTMENT OF PSYCHIATRY & HUMAN BEHAVIOR, JACKSON, MS 39216-4500
(601) 815-1368
(601) 984-5885
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-1368
(601) 984-5885

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
T-2953
MS
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/04/2015
Last updated
07/21/2015
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