Individual
JEANNE ANN REA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
215 MARION AVE, MCCOMB, MS 39648-2705
(601) 249-5500
Mailing address
PO BOX 4507, JACKSON, MS 39296-4507
(601) 936-0682
(601) 936-0686
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
09186
MS
207L00000X
Anesthesiology Physician
53061
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00012932
—
MS
01
—
050057449
MEDICARE RAILROAD
MS
Enumeration date
08/23/2006
Last updated
08/15/2023
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