Individual
DR. JESSICA K MAGNUSSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
21 HUGHES RD, SUITE 2, MADISON, AL 35758-3039
(256) 772-2037
(256) 772-9523
Mailing address
21 HUGHES RD, SUITE 2, MADISON, AL 35758-3039
(256) 772-2037
(256) 772-9523
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
29130
SC
208000000X
Pediatrics Physician
Primary
30253
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291302
—
SC
Enumeration date
08/09/2006
Last updated
09/14/2011
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