Organization
GUARDIAN ANGEL HEALTHCARE II, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAULETTE BUTLER (ADMINISTRATOR)
(601) 732-8473
Entity
Organization
Contact information
Practice address
347 MAGNOLIA DR, RALEIGH, MS 39153-6011
(601) 782-9997
(601) 782-4918
Mailing address
41 S HALL RD, MORTON, MS 39117-8057
(601) 732-8473
(601) 732-8037
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
07565
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03920570
—
MS
Enumeration date
01/24/2007
Last updated
08/22/2020
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