Individual
DR. MARK EDMUND LADNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 E WOODROW WILSON AVE, JACKSON, MS 39216-5116
(601) 362-4471
(601) 368-3904
Mailing address
419 FOREST LN, RIDGELAND, MS 39157-4176
(601) 362-4471
(601) 368-3904
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
13651
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00116511
—
MS
05
—
04507528
—
MS
Enumeration date
09/22/2006
Last updated
04/27/2016
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