Individual
GLENDA JEAN SCALLORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
315 HOLLEY LN, RIDGELAND, MS 39157-3547
(601) 898-1706
Mailing address
315 HOLLEY LN, RIDGELAND, MS 39157-3547
(601) 898-1706
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
06024
MS
Other
Enumeration date
05/09/2009
Last updated
05/09/2009
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