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Individual

DR. KAISHA RENADA GRIFFIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
350 W WOODROW WILSON AVE, JACKSON, MS 39213-7681
(601) 709-5130
(601) 709-5151
Mailing address
105 MASON COVE, MADISON, MS 39110

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
21093
MS
208000000X
Pediatrics Physician
T-1990
MS
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/25/2007
Last updated
06/25/2011
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