Individual
DOUGLAS WRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(662) 312-3569
Mailing address
2476 E NORTHSIDE DR, JACKSON, MS 39211-4924
(662) 312-3569
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
910154
MS
Other
Enumeration date
08/04/2025
Last updated
08/04/2025
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