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Individual

DR. KENNETH E CLEVELAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1190 NORTH STATE STREET, SUITE 502, JACKSON, MS 39202
(601) 944-1781
(601) 353-0439
Mailing address
1190 NORTH STATE STREET, SUITE 502, JACKSON, MS 39202
(601) 944-1781
(601) 353-0439

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
15419
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00123961
MS
Enumeration date
10/05/2006
Last updated
07/08/2007
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