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Individual

MR. MUKESH JAIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
7615 CLARINGTON CV, SOUTHAVEN, MS 38671-5647
(662) 536-2500
(662) 536-2505
Mailing address
7615 CLARINGTON CV, SOUTHAVEN, MS 38671-5647
(662) 536-2500
(662) 536-2505

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
14601
MS
174400000X
Specialist
25718
TN
207R00000X
Internal Medicine Physician
Primary
14601
MS
208M00000X
Hospitalist Physician
14601
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05128319
MS
05
06326035
MS
Enumeration date
07/07/2006
Last updated
11/20/2019
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