Individual
DR. STEPHANIE GONG
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) 815-2005
(601) 815-0434
Mailing address
2500 N. STATE STREET, CBO-SUITE 4200, JACKSON, MS 39216-4500
(601) 496-9794
(601) 815-0434
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
24274
MS
Other
Enumeration date
07/07/2009
Last updated
09/29/2020
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