Individual
ANALISE DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
970 LAKELAND DR STE 61, JACKSON, MS 39216-4634
(601) 982-7850
Mailing address
970 LAKELAND DR STE 61, JACKSON, MS 39216-4634
(601) 982-7850
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
70752
CT
207RI0011X
Interventional Cardiology Physician
Primary
33261
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/16/2017
Last updated
08/01/2025
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