Individual
LORI MCMULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2111 14TH ST, MERIDIAN, MS 39301-4041
(601) 693-3834
(601) 484-3225
Mailing address
2111 14TH ST, MERIDIAN, MS 39301-4041
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
R668982
MS
Other
Enumeration date
09/14/2006
Last updated
07/08/2007
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