Individual
DR. DAVID B JOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7601 SOUTHCREST PKWY, SOUTHAVEN, MS 38671-4739
(662) 772-2980
(662) 772-3102
Mailing address
965 RIDGE LAKE BLVD, SUITE 102, MEMPHIS, TN 38120-9401
(901) 227-4068
(901) 227-8591
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
22868
MS
208M00000X
Hospitalist Physician
22868
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/11/2010
Last updated
12/05/2013
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