Individual
VIRGINIA LITTLE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
350 W WOODROW WILSON AVE, JACKSON MEDICAL MALL, SUITE 454, JACKSON, MS 39213-7681
(601) 987-3965
(601) 987-4176
Mailing address
PO BOX 1700, JACKSON, MS 39215-1700
(601) 987-3965
(601) 987-5560
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
10098
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00122599
—
MS
01
—
10098
MS BOARD OF MEDICAL LICENSURE
MS
Enumeration date
12/18/2006
Last updated
03/07/2023
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