Individual
MARILYN K MCLEOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1400 E UNION ST, GREENVILLE, MS 38703-3246
(662) 378-3783
Mailing address
PO BOX 23998, JACKSON, MS 39225-3998
(662) 725-2749
(662) 725-2741
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
14963
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00118461
—
MS
05
—
1528013
—
LA
Enumeration date
08/25/2006
Last updated
07/08/2007
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