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Individual

MR. JOHN A BELLAN JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
501 MARSHALL ST, STE 104, JACKSON, MS 39202
(601) 969-6404
(601) 973-4541
Mailing address
965 RIDGE LAKE BLVD STE 103, MEMPHIS, TN 38120-9446
(901) 227-3255
(901) 227-8591

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
16704
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00121619
MS
Enumeration date
08/02/2006
Last updated
07/10/2018
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