Individual
MARCUS D WALKINSHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5180
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5180
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
MD00019467
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02581271
—
MS
01
—
P01555815
RAILROAD MEDICARE PTAN
MS
Enumeration date
10/18/2006
Last updated
01/06/2016
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