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Individual

DR. FRANK JEFFERSON CRIDDLE III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-6426
(601) 984-6439
Mailing address
965 RIDGE LAKE BLVD STE 315, MEMPHIS, TN 38120-9401
(901) 227-8591

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
13166
MS
207RI0200X
Infectious Disease Physician
13166
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
07076260
MS
01
13166
MEDICAL LICENSE NUMBER
MS
01
P01212522
RAILROAD MEDICARE
MS
Enumeration date
07/19/2006
Last updated
11/12/2021
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