Individual
DR. GINA DENISE JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, DEPARTMENT OF OTOLARYNGOLOGY, JACKSON, MS 39216-4500
(601) 984-5160
Mailing address
2500 N STATE ST, DEPARTMENT OF OTOLARYNGOLOGY, JACKSON, MS 39216-4500
(601) 984-5160
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
20779
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20779
MEDICAL LICENSE
MS
Enumeration date
02/11/2008
Last updated
06/05/2012
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