Individual
MS. SUSAN PEE MIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NPC
Contact information
Practice address
2500 NORTH STATE STREET, DEPARTMENT OF MEDICINE DIVISION OF GEN INTERNAL MED, JACKSON, MS 39216
(601) 815-5670
(601) 984-6870
Mailing address
PO BOX 24146, UNIVERSITY PHYSICIANS PLLC, JACKSON, MS 39225-4146
(601) 815-5047
(601) 815-9596
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R784973
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06370000
—
MS
Enumeration date
05/17/2006
Last updated
08/20/2008
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